Diagnostic and Prognostic Values of Serum C-reactive Protein, Procalcitonin, Soluble Urokinase Plasminogen Activator Receptor, and Neopterin Levels in Hospitalized Patients in the Intensive Care Unit with Ventilator-associated Pneumonia

Abstract

Introduction: This study investigated the association and prognostic values of serum C-reactive protein (CRP), procalcitonin (PCT), soluble urokinase plasminogen activator receptor (suPAR), and neopterin levels in patients with ventilator-associated pneumonia (VAP). Materials and Methods: This prospective observational age-and gender-matched study included 38 adult patients who were diagnosed with VAP and 40 adult patients without VAP. The Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Clinical Pulmonary Infection Scores were calculated, and the daily positive end-expiratory pressure values of the patients were recorded. The serum levels of CRP, PCT, suPAR, and neopterin were measured once in controls (control group) and on days 0, 3, and 5 and at the end of treatment in the VAP group. Results: The CRP, PCT, neopterin, and suPAR levels were significantly higher in the VAP group than in the control group. APACHE II and SOFA values were higher in the VAP group than in the control group. C-reactive protein value on day 0 of >14.5 ng/ml and PCT level on day five of >1.23 ng/ml were 100% specific for the prediction of mortality in the VAP group. Conclusion: Measuring CRP, PCT, neopterin, and suPAR levels may aid in the early diagnosis of VAP in patients hospitalized in the ICU. High CRP and PCT levels, as well as high APACHE II and SOFA scores, may have prognostic value in the follow-up of patients with VAP.

Keywords

• apache
• prognosis
• sofa
• ventilator-associated pneumonia
• soluble urokinase plasminogen activator receptor (supar)