Procalcitonin kinetics in the prognosis of severe community-acquired pneumonia

Intensive Care Med. 2006 Mar;32(3):469-72. doi: 10.1007/s00134-005-0047-8. Epub 2006 Feb 14.


Objectives: Procalcitonin (PCT) kinetics is a good prognosis marker in infectious diseases, but few studies of community-acquired pneumonia (CAP) have been performed in intensive care units (ICU). We analyzed the relationship between PCT kinetics and outcome in ICU patients with severe CAP.

Design and setting: Prospective observational study in a 16-bed university hospital ICU.

Patients: 100 critically ill patients with community-acquired pneumonia.

Measurements and results: Median PCT was 5.2 ng/ml on day 1 and 2.9 ng/ml on day 3. It increased from day 1 to day 3 in nonsurvivors but decreased in survivors. In multivariate analysis four variables were associated with death: invasive ventilation (odds ratio 10-), multilobar involvement (5.6-), LOD score (6.9-), and PCT increase from day 1 to day 3 (4.5-). In intubated patients with a PCT level below 0.95 ng/ml on day 3 the survival rate was 95%.

Conclusion: Increased PCT from day 1 to day 3 in severe CAP is a poor prognosis factor. A PCT level less than 0.95 ng/ml on day 3 in intubated patients is associated with a favorable outcome.

MeSH terms

  • Aged
  • Calcitonin / analysis
  • Calcitonin / pharmacokinetics*
  • Calcitonin Gene-Related Peptide
  • Community-Acquired Infections* / diagnosis
  • Community-Acquired Infections* / physiopathology
  • France
  • Hospitals, University
  • Humans
  • Intensive Care Units
  • Middle Aged
  • Pneumonia / diagnosis*
  • Prospective Studies
  • Protein Precursors / analysis
  • Protein Precursors / pharmacokinetics*
  • Severity of Illness Index


  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide