Serum Procalcitonin and Outcomes in Severe Pediatric Pneumonia: A Secondary Analysis of An Observational Multicenter Study
Abstract
BACKGROUND
Evidence on procalcitonin's role in the management of severe pediatric pneumonia is limited. This study aims to determine the association between procalcitonin and severity of illness in children with severe pneumonia.
METHODS
In this secondary analysis of a multi-center study in Asia, peak serum procalcitonin (measured within 5 days) was categorized into four groups (10.0 ng/mL). The primary outcome was mortality and secondary outcomes were acute respiratory distress syndrome (ARDS), septic shock, and multiorgan dysfunction. Area under the receiver operating curve (AUROC) analysis was used to assess the association of peak procalcitonin levels with primary and secondary outcomes.
RESULTS
Of 846 patients, 344 had early procalcitonin data. Mortality increased in groups with higher peak procalcitonin levels [8/162 (4.9%), 3/69 (4.4%), 8/55 (14.6%) vs. 11/58 (19.0%); p=0.002]. The proportion of patients with ARDS [23/162 (14.2%), 14/69 (20.3%), 10/55 (18.2%) vs. 25/58 (43.1%); p<0.001], septic shock [8/162 (4.9%), 10/69 (14.5%), 13/55 (23.2%) vs. 32/58 (55.2%); p<0.001], multiorgan failure [19/162 (11.7%), 13/69 (18.8%), 12/55 (21.4%) vs. 23/58 (39.7%); p<0.001] was also higher in groups with higher peak procalcitonin levels. The AUROC for procalcitonin showed moderate discrimination for mortality [0.69 (95%CI 0.58, 0.80)] and good discrimination for septic shock [0.81 (95%CI 0.76, 0.87)].
CONCLUSION
In critically ill children with severe pneumonia, higher serum…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 846 participants or records.
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