Serum procalcitonin level as a predictor of NIPPV and mortality in patients with COPD at Zagazig University Hospitals

Abstract

Background Several reports showed the diagnostic value of procalcitonin (PCT) level in the serum to predict a bacterial cause of acute exacerbations in cases of chronic obstructive pulmonary disease (COPD); however, measurement of PCT for detection of prognosis in case of severe COPD exacerbation has been less studied. Aim The aim was to assess the value of using measured PCT in the serum to predict the severity, the progression, and the need of noninvasive positive pressure ventilation (NIPPV) in patients with COPD with acute exacerbation. Patients and methods This study was done at Chest Department, Zagazig University Hospital, during the period from January 2017 to July 2018. It included 100 patients with COPD who were admitted to chest ICU. They are classified into group A, which included 59 patients who needed NIPPV, and group B, which included 41 patients who did not need NIPPV. Serum PCT level was measured three times. Results PCT level was higher in group A than group B especially second (0.9±0.4 vs. 0.5±0.2) and third samples (2±1.9 vs. 0.6±0.9), which showed high statistical significance (P<0.001), with high death rate among group A patients (45.80%). Increasing PCT second sample was associated with progressive global initiative for chronic obstructive lung disease stage. Conclusion Serum PCT level is a good predictor of severity of progression and the need of NIPPV in patients with acute exacerbation of COPD.

Keywords

• acute exacerbations of chronic obstructive pulmonary disease
• noninvasive positive pressure ventilation
• procalcitonin