Clinical significance of procalcitonin in early diagnosis of acute left heart failure complicated with pulmonary infection in the elderly / 中华老年医学杂志

ABSTRACT

Objective To investigate clinical significance of procalcitonin (PCT)in the early diagnosis of acute left heart failure complicated with pulmonary infection in the elderly.Methods A total of 113 patients with acute left heart failure or acute left heart failure complicated with pulmonary infection who were admitted into our emergency department from August 2012 to February 2018 were retrospectively analyzed.Data of serum concentration of PCT were collected on the first and third days after admission.The diagnostic values of serum PCT and C-reaction protein(CRP)were evaluated based on the patient's diagnostic data.ROC curves were plotted for PCT,and its cut-off value was calculated.Results Serum levels of PCT on the first and third days after admission were higher in pulmonary infection group than in left heart failure group[(2.45±0.42) μg/L vs.(0.54±0.03) μg/L,(1.25±0.17) μg/L vs.(0.43±0.03) μg/L,t =34.27 and 35.78,P=0.000 and 0.000].The diagnostic specificity,positive predictive value,and negative predictive value of PCT were better than those of CRP(x2 =4.97,4.76 and 4.17,P =0.030,0.030 and 0.040).There was no significant difference in the diagnostic sensitivity between PCT and CRP (x2 =3.05,P =0.080).The best diagnostic cut-off value of PCT was 0.597 μg/L in which the sensitivity of diagnosis of heart failure complicated with pneumonia was 91.07％ and the specificity was 90.77％.Conclusions Serum PCT test can assist the early diagnosis of acute left heart failure complicated with pulmonary infection in elderly patients with high sensitivity and specificity.The best diagnostic cut-off value of PCT is 0.597 μg/L.Based on serum PCT test,early rational use of antibiotics for controlling acute left heart failure complicated with pulmonary infection in elderly patients is worthy of generalization.