Procalcitonin at Zero and 24 Hours as a Prognostic Factor in Patients With Pneumonia

Completed

• Conditions: Pneumonia
• Interventions: Diagnostic Test: Procalcitonin lab test

• Registration Number: NCT03711227
• Lead Sponsor: Spectrum Health - Lakeland

Brief Summary

Procalcitonin levels checked initially and at 24 hours will correlate with disease severity, morbidity, and mortality. Patients who have a higher procalcitonin level initially and at 24 hours will likely have higher qSOFA scores, longer lengths of stay, longer duration of antibiotics and higher 30 day mortality rates.

Detailed Description

A procalcitonin order bundle will be created for admitted patients with pneumonia. This prepopulated bundle includes an initial and 24 hour procalcitonin level, much like the current initial and 4 hour lactate orders are set-up. These patients will receive treatment for their pneumonia as is deemed appropriate by their care teams, both in the Emergency Department and while an inpatient. Then, after discharge, the 30 day mortality, length of stay, choice of antibiotic therapy, and qSOFA score (which will be retroactively calculated) will be compared to the patient's initial and 24 hour procalcitonin level.

Study Timeline

• Study First Submitted: 2018-06-02
• Study Start: 2018-07-17
• Study First Submitted QC: 2018-10-16
• Study First Posted: 2018-10-18
• Primary Completion: 2019-08-01
• Study Completion: 2019-08-01
• Status Verified: 2019-10
• Last Update Submitted: 2024-11-26
• Last Update Posted: 2024-11-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 185

Inclusion Criteria

• All patients seen at Lakeland St. Joseph and Niles Hospitals in the emergency department and who are then subsequently admitted with pneumonia at Lakeland St. Joseph and Niles Hospitals

Exclusion Criteria

• Any patients not admitted with pneumonia, any patients who are admitted with another primary diagnosis other than pneumonia, any patients who do not have an initial or 24 hour procalcitonin level result, and any patients less than 18 years old

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Procalcitonin lab test	Procalcitonin lab test	A procalcitonin order bundle will be created for admitted patients with pneumonia. This prepopulated bundle includes an initial and 24 hour procalcitonin level. These patients will receive treatment for their pneumonia as is deemed appropriate by their care teams, both in the Emergency Department and while an inpatient. Then, after discharge, the 30 day mortality, length of stay, choice of antibiotic therapy, and qSOFA score (which will be retroactively calculated) will be compared to the patient's initial and 24 hour procalcitonin level.

Primary Outcome Measures

Name	Time	Method
Change in Procalcitonin level	Measured at baseline and at 24 hours	Change in procalcitonin level in the blood serum

Secondary Outcome Measures

Name	Time	Method
30 Day Mortality	30 days	Number of patients who expire vs those alive at 30 days
Length of stay	an average of 30 days	Length of stay in days, total stay from admission until discharge
Duration of antibiotics	an average of 30 days	Antibiotic treatment length in days
qSOFA score	baseline and at 24 hours	qSOFA score is based on blow blood pressure, high respiratory rate, and altered mental status

Trial Locations

Locations (1)

Lakeland Regional Healthcare; 🇺🇸 Saint Joseph, Michigan, United States