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Usefulness of procalcitonin level as an outcome predictor of adult bacterial meningitis

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Abstract

Acute bacterial meningitis is rare, but can be fulminant unless rapidly evaluated and treated. The aim of this study was to evaluate whether serum procalcitonin (PCT) levels could predict unfavorable outcomes of bacterial meningitis. We retrospectively reviewed the medical records of 604 meningitis patients from the emergency department (ED) of our tertiary care, university-affiliated hospital over a five-year period. We analyzed the ability of blood PCT levels on admission to predict the outcome at discharge (defined as Glasgow Outcome Scale scores of 1–4). Of 71 patients with acute bacterial meningitis, 28 (39 %) experienced an unfavorable outcome at discharge (overall mortality: 5 %). The serum PCT level at admission was a predictive indicator of an unfavorable outcome [adjusted odds ratio: 1.04, 95 % confidence interval (CI) 1.01–1.09, p = 0.05]. As assessed using receiver operating characteristic curves for an unfavorable outcome, the area under the PCT curve was 0.708 (95 % CI 0.58–0.84, p < 0.01). When the PCT cutoff value was ≥1.10 ng/mL, the sensitivity, specificity, positive predictive value and negative predictive value for an unfavorable outcome were 75, 70, 62, and 81 %, respectively. An association between the serum PCT level and an unfavorable outcome is observed.

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Abbreviations

CSF:

Cerebrospinal fluid

ED:

Emergency department

GOS:

Glasgow outcome scale

IQR:

Interquartile range

PCT:

Procalcitonin

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Byuk Sung Ko, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong-Woo Seo & Won Young Kim

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  1. Byuk Sung Ko
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  2. Seung Mok Ryoo
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  3. Shin Ahn
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  4. Chang Hwan Sohn
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  5. Dong-Woo Seo
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Correspondence to Won Young Kim.

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Human and animal rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committees and with the 1964 Declaration of Helsinki and its later amendments, or comparable ethical standards. This article does not contain any studies with human participants or animals performed by any of the authors.

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Ko, B.S., Ryoo, S.M., Ahn, S. et al. Usefulness of procalcitonin level as an outcome predictor of adult bacterial meningitis. Intern Emerg Med 12, 1003–1009 (2017). https://doi.org/10.1007/s11739-016-1509-4

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  • DOI: https://doi.org/10.1007/s11739-016-1509-4

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