Diagnostic and Prognostic Values of Pleural Fluid Procalcitonin in Parapneumonic Pleural Effusions.
Chest. 2009 Mar 2;
Authors: Lin MC, Chen YC, Wu JT, Ko YC, Wang CC
Background The role of procalcitonin (PCT) in parapneumonic pleural effusion (PPPE) as a diagnostic and prognostic biomarker of the outcome has not been examined before. Methods From the emergency department, 82 adult patients with pleural effusions were enrolled in this prospective study and divided into two groups-PPPE group (n = 45) and nonPPPE group (n = 37). Pleural fluid (PF) PCT and serum (S) PCT in all the patients were determined after enrollment as well as on day 3 in the PPPE group only by a newly developed time-resolve amplified cryptal emission assay. Results Both PF-PCT and S-PCT levels were significantly higher in the PPPE group than the nonPPPE group (p = 0.01 and 0.0003, respectively). S-PCT had a better diagnostic performance than PF-PCT, with an area under the receiver-operating characteristic curve value of 0.834 for S-PCT and 0.752 for PF-PCT (p = 0.006). In the PPPE group, both PF-PCT and S-PCT levels on days 1 and 3 were significantly higher in patients with high-severity risk classes (all p values < 0.05). Day 3 PF-PCT to S-PCT ratios (PF-PCT/S-PCT) were significantly lower in patients who need chest tube drainage for > 7.5 days (corrected p = 0.02). Conclusion S-PCT has higher diagnostic accuracy than PF-PCT in differentiating PPPE from nonPPPE. However, both PF-PCT and S-PCT are useful in the severity assessment of patients with PPPE. The PF-PCT/S-PCT ratio may help to predict prolonged chest tube drainage.
PMID: 19255287 [PubMed - as supplied by publisher]