Procalcitonin and albumin as prognostic biomarkers in elderly patients with a risk of bacterial infection

J Int Med Res. 2018 Jul;46(7):2606-2614. doi: 10.1177/0300060518766640. Epub 2018 Apr 16.

Abstract

Aim This study was performed to investigate serum procalcitonin (PCT) and albumin (Alb) as prognostic biomarkers in elderly patients at risk of bacterial infection. Methods Serum PCT was measured in 270 hospitalized patients (mean age, 77.4 years) with suspected bacterial infection. The PCT-negative (<0.5 ng/mL) and PCT-positive (≥0.5 ng/mL) groups comprised 155 and 115 patients, respectively. Logistic regression analysis was performed with various clinical laboratory test values as independent variables and PCT positivity/negativity as the dependent variable. Results C-reactive protein (CRP) was the only independent variable significantly associated with PCT positivity/negativity. In the survival analysis, the 30-day in-hospital death rate was significantly higher in the PCT-positive than -negative group. Within the Alb-positive group (>2.5 g/dL), no significant difference in survival was observed between the PCT-positive and -negative groups. However, within the Alb-negative group (≤2.5 g/dL), the survival rate was significantly lower in the PCT-positive than -negative group. PCT was strongly associated with CRP and Alb, and having both PCT positivity and Alb negativity was a prognostic factor for elderly people at risk of bacterial infection. Conclusions Combined measurement of PCT with Alb is expected to be a valuable tool to assess prognosis in elderly people at risk of bacterial infection.

Keywords: Procalcitonin; albumin; bacterial infection; elderly patient; prognosis; survival analysis.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / blood*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Procalcitonin / blood*
  • Prognosis
  • Serum Albumin / analysis*

Substances

  • Biomarkers
  • Procalcitonin
  • Serum Albumin
  • C-Reactive Protein