title: Usefulness of procalcitonin level as an outcome predictor of adult bacterial meningitis.
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.
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Byuk Sung
authors.initials: BS
authors.lastname: Ko
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Seung Mok
authors.initials: SM
authors.lastname: Ryoo
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea. wonpia73@naver.com.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002116:Calcitonin / Q000032:analysis* / Q000097:blood; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D056910:Republic of Korea; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D002116:Calcitonin
keywords: Bacterial meningitis; Emergency department; Outcome; Procalcitonin