Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Comparison of Serum Procalcitonin Levels between Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and Patients with Chronic Obstructive Pulmonary Disease

Author(s): Sakineh Haj Jafari Nejad, Anahita Behzadi, Mohsen Shafiepour*, Behnam Dalfardi, Ahmad Alinaghi Langari, Habibeh Ahmadipour, Ahmad Shafahi and Mitra Samareh Fekri

Volume 19, Issue 2, 2023

Published on: 31 March, 2023

Page: [146 - 153] Pages: 8

DOI: 10.2174/1573398X19666230315124509

Price: $65

Abstract

Background: This study aimed to compare the serum levels of procalcitonin in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the patients with chronic obstructive pulmonary disease (COPD) in the emergency ward of Afzalipour Hospital in Kerman.

Methods: This cross-sectional study was conducted on 45 patients with stable COPD and 45 patients with AECOPD. Patients were divided into four groups based on COPD severity assessment. Serum procalcitonin levels were measured using an ELISA kit.

Results: The mean age of patients in the exacerbation and the stable group was 60.97 ± 12.61 and 62.53 ± 11.04 years, respectively. Serum procalcitonin levels in two exacerbation groups (215.22 ± 19.84) were higher than stable groups (127.92 ± 8.97) (P = 0.001). The accuracy of this test for diagnosing acute attack in terms of AECOPD was 77%, and the serum procalcitonin level of 132.6 was found to be the best cut-off point to diagnose acute disease. The mean serum procalcitonin levels of stage D patients in the acute attack group were substantially higher than those of stages D and B patients in the stable group (P = 0.001). Serum procalcitonin levels were related to body mass index (P = 0.01), post-bronchodilator FEV1/FVC (P = 0.028), and the number of hospitalizations per year (P = 0.001). By increasing the serum procalcitonin levels, BMI and number of admissions per year increase, and post-bronchodilator FEV1/FVC decreases.

Conclusion: The mean serum levels of procalcitonin in the group with attacks due to COPD was significantly higher than the stable group.

Graphical Abstract

[1]
Wu W, Kaminski N. Chronic lung diseases. Wiley Interdiscip Rev Syst Biol Med 2009; 1(3): 298-308.
[http://dx.doi.org/10.1002/wsbm.23] [PMID: 20835999]
[2]
Mason RJ, Broaddus VC, Martin TR. King TE Jr, Schraufnagel D, Murray JF, Nadal JA Murray and Nadel’s textbook of respiratory medicine. (5th ed.), Philadelphia: Saunders Elsevier 2010.
[3]
Wang H, Naghavi M, Allen C, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1459-544.
[http://dx.doi.org/10.1016/S0140-6736(16)31012-1] [PMID: 27733281]
[4]
Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the global burden of disease study 2010. Lancet 2012; 380(9859): 2095-128.
[http://dx.doi.org/10.1016/S0140-6736(12)61728-0] [PMID: 23245604]
[5]
Ray S. Guarascio, Finch CK, Self T. The clinical and economic burden of chronic obstructive pulmonary disease in the USA. Clinicoecon Outcomes Res 2013; 5: 235-45.
[http://dx.doi.org/10.2147/CEOR.S34321] [PMID: 23818799]
[6]
Wedzicha JA, Seemungal TAR. COPD exacerbations: Defining their cause and prevention. Lancet 2007; 370(9589): 786-96.
[http://dx.doi.org/10.1016/S0140-6736(07)61382-8] [PMID: 17765528]
[7]
Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106(2): 196-204.
[http://dx.doi.org/10.7326/0003-4819-106-2-196] [PMID: 3492164]
[8]
Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections. Eur Respir J 2005; 26(6): 1138-80.
[http://dx.doi.org/10.1183/09031936.05.00055705] [PMID: 16319346]
[9]
Seemungal T, Harper-Owen R, Bhowmik A, et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164(9): 1618-23.
[http://dx.doi.org/10.1164/ajrccm.164.9.2105011] [PMID: 11719299]
[10]
Vollenweider DJ, Frei A, Steurer-Stey CA, Garcia-Aymerich J, Puhan MA. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Libr 2018; 2018(10): CD010257.
[http://dx.doi.org/10.1002/14651858.CD010257.pub2] [PMID: 30371937]
[11]
Miravitlles M, Kruesmann F, Haverstock D, Perroncel R, Choudhri SH, Arvis P. Sputum colour and bacteria in chronic bronchitis exacerbations: A pooled analysis. Eur Respir J 2012; 39(6): 1354-60.
[http://dx.doi.org/10.1183/09031936.00042111] [PMID: 22034649]
[12]
Stockley RA, O’Brien C, Pye A, Hill SL. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD. Chest 2000; 117(6): 1638-45.
[http://dx.doi.org/10.1378/chest.117.6.1638] [PMID: 10858396]
[13]
Clark TW, Medina MJ, Batham S, Curran MD, Parmar S, Nicholson KG. C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD. Eur Respir J 2015; 45(1): 76-86.
[http://dx.doi.org/10.1183/09031936.00092214] [PMID: 25186260]
[14]
Peng C, Tian C, Zhang Y, Yang X, Feng Y, Fan H. C-reactive protein levels predict bacterial exacerbation in patients with chronic obstructive pulmonary disease. Am J Med Sci 2013; 345(3): 190-4.
[http://dx.doi.org/10.1097/MAJ.0b013e318253c921] [PMID: 23221507]
[15]
Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: Cluster-randomised, single-blinded intervention trial. Lancet 2004; 363(9409): 600-7.
[http://dx.doi.org/10.1016/S0140-6736(04)15591-8] [PMID: 14987884]
[16]
Schuetz P, Christ-Crain M, Thomann R, et al. Effect of procalcitonin-based guidelines vs. standard guidelines on antibiotic use in lower respiratory tract infections: The ProHOSP randomized controlled trial. JAMA 2009; 302(10): 1059-66.
[http://dx.doi.org/10.1001/jama.2009.1297] [PMID: 19738090]
[17]
Schuetz P, Müller B, Christ-Crain M, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Evid Based Child Health 2013; 8(4): 1297-371.
[http://dx.doi.org/10.1002/ebch.1927] [PMID: 23877944]
[18]
Wang JX, Zhang SM, Li XH, Zhang Y, Xu ZY, Cao B. Acute exacerbations of chronic obstructive pulmonary disease with low serum procalcitonin values do not benefit from antibiotic treatment: A prospective randomized controlled trial. Int J Infect Dis 2016; 48: 40-5.
[http://dx.doi.org/10.1016/j.ijid.2016.04.024] [PMID: 27155210]
[19]
Mathioudakis AG, Chatzimavridou-Grigoriadou V, Corlateanu A, Vestbo J. Procalcitonin to guide antibiotic administration in COPD exacerbations: A meta-analysis. Eur Respir Rev 2017; 26(143): 160073.
[http://dx.doi.org/10.1183/16000617.0073-2016] [PMID: 28143877]
[20]
Garg R, Pandey S, Kant S, Verma A, Gaur P. Serum procalcitonin levels in chronic obstructive pulmonary disease patients in North Indian Population. Ann Afr Med 2019; 18(2): 103-7.
[http://dx.doi.org/10.4103/aam.aam_44_18] [PMID: 31070153]
[21]
Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med 2017; 195(5): 557-82.
[http://dx.doi.org/10.1164/rccm.201701-0218PP] [PMID: 28128970]
[22]
Falsey A, Becker K, Swinburn A, et al. Utility of serum procalcitonin values in patients with acute exacerbations of chronic obstructive pulmonary disease: A cautionary note. Int J Chron Obstruct Pulmon Dis 2012; 7: 127-35.
[http://dx.doi.org/10.2147/COPD.S29149] [PMID: 22399852]
[23]
Taghizadieh A, Soleimanpour H, Rahmani F, Shahsavari Nia K, Khodaverdizadeh H. Comparison of serum levels of procalcitonin and C-reactive protein in patients with community acquired pneumonia and COPD exacerbation. Iran Red Crescent Med J 2016; 18(12): e25811.
[http://dx.doi.org/10.5812/ircmj.25811]
[24]
Çolak A, Yılmaz C, Toprak B, Aktoğu S. Procalcitonin and CRP as biomarkers in discrimination of community-acquired pneumonia and exacerbation of COPD. J Med Biochem 2017; 36(2): 122-6.
[http://dx.doi.org/10.1515/jomb-2017-0011] [PMID: 28680355]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy