Table 1.
Demographics, clinical, and outcome data among patients with PCT < 0.5 μg/L vs. those with PCT > 0.5 μg/L.
| PCT < 0.5 | PCT > 0.5 | P-value when significant | |
|---|---|---|---|
| Patient data and demographics | |||
| Number of patients (n) | 25 | 27 | |
| Age (years)a | 54.4 (±11.3) | 57.9 (±10.0) | |
| Male (%) | 72 | 55.6 | |
| Severity of illness and interventions | |||
| Charlson's Comorbidity Indexb | 1 (0–3) | 2 (1–3) | |
| Days symptomatic before admissionb | 10 (6.75–14) | 7 (6–11) | |
| True positive microbiology,cn (%) (first 7 days) | 2 (8%) | 7 (26%) | |
| Temperature °C, day 1b | 37.1 (36.7–37.7) | 37.4 (36.6–38.1) | |
| Temperature °C, average over first weekb | 36.8 (36.4–37.5) | 37.1 (36.5–37.7) | <0.001 |
| Median SOFA score pointsb | 3 (3–4) | 5 (4–7) | <0.001 |
| Median APACHE II scoreb | 12 (8–15) | 19 (12.5–24.5) | 0.012 |
| Ventilation support | |||
| Invasive ventilation no (%) | 15 (60%) | 21 (77.8%) | |
| Non-invasive ventilation no (%) | 10 (40%) | 6 (22.2%) | |
| Renal replacement (in first 7 days) | 0 | 8 | 0.0044 |
| Antibiotic therapy in first 7 daysd (days)b | 5 (4–5) | 7 (7–7) | <0.001 |
| Blood markers | |||
| White cell count (109/L) (first week)b | 8.7 (6.9–10.7) | 9.9 (7.3–14.0) | 0.001 |
| White cell count (109/L) (day 1)b | 9.6 (6.32–11.5) | 10.6 (7.08–12) | |
| CRP (mg/L) (first week)b | 138 (88.8–202) | 232 (156–312) | <0.001 |
| CRP (mg/L) (day 1) | 139 (112–182) | 174 (126–276) | |
| Lymphocyte cell count (109/L) (first week)b | 1.05 (0.8–1.42) | 0.8 (0.6–1.37) | <0.001 |
| Lymphocyte cell count (109/L) (day 1)b | 0.95 (0.7–1.3) | 0.9 (0.6–1.28) | |
| Outcome data | |||
| Alive at day 30 (%) | 96 | 85.2 | |
| Length of ICU stay (days)b | 5 (3–16) | 15 (7–21.75) | 0.03 |
| Percentage discharged from hospital at endpoint of study | 96% | 59% | |
| Length of hospital stay (days)b,e | 15.5 (11–24.2) | 20 (10–23) |
Description data, severity score, and outcome of procalcitonin (PCT) < 0.5 μg/L vs. PCT > 0.5 μg/L.
APACHE II, Acute Physiology and Chronic Health Evaluation II; CRP, C-reactive protein; SOFA, Sequential Organ Failure Assessment.
Data are presented as mean ± standard deviation.
Data are presented as median and interquartile range.
Culture from normally sterile site e.g. blood culture; or pure growth of a significant isolate from bronchoalveolar lavage, or positive legionella or pneumococcal antigen tests or an organism deemed significant by an infection specialist.
Compliance with de-escalate or stop antibiotics in the low PCT group was only 56%, i.e. 44% of the time clinicians ignored the low PCT results and carried on antibiotics.
Amongst patients discharged from hospital (n = 24 [PCT < 0.5] and n = 16 [PCT > 0.5]). Data were collected from our intensive care clinical information system (CIS) (Metavision, iMDsoft, Tel Aviv, Israel) and hospital laboratory information system (eQuest, University Hospital Southampton, Southampton, UK). All statistical analysis and data processing were performed using R (R Core Team, Vienna, Austria). Normally distributed data are presented as mean and standard deviation, whereas data suspected to be non-normally distributed were confirmed by a Shapiro–Wilk test. These data are presented as median and IQR. Significance testing of continuous, non-parametric variables was performed using a Mann–Whitney U-test. Categorical variables were examined using Fisher's Exact test. A cut-off of P < 0.05 was used throughout.