PCT levels were higher, and remained persistently elevated, in non-survivors. Both, initial and maximum PCT values correlated with the maximum SOFA score and were a reasonable predictor of the risk of death within 28 days in these patients. In patients with severe pneumonia, initial PCT measurement allows a risk stratification similar to the APACHE II-score. The data agree with previous observations. In two studies in the emergency department with more than 1,600 patients each, PCT-values < 0.1 ng/ ml in CAP were associated with a low risk of death independent of the clinical risk assessment [17, 18] . PCT was also capable of identifying an unfavorable outcome in CAP patients staying at the ICU [28] . Impact of PCT-assessment is less well investigated in VAP and HAP compared to CAP. Patients with HAP not treated in an ICU have low median PCT values of 0.22 ng/ml [29] . In a single center study conducted in 44 patients with VAP, Duflo et al. found PCT to be significantly elevated in non-survivors: The best cut-off for serum PCT in the non-survivors in the VAP group was 2.6 ng/ml with a sensitivity of 74% and a specificity of 75% [7] . Likewise, Luyt et al. found high median PCT levels of about 3 ng/ml at Day 1 in patients with unfavorable outcomes during the clinical course of microbiologically proven VAP (n = 63) [19] . Interestingly, multivariate analyses further supported that serum PCT levels on days 1, 3, and 7 were strong predictors of unfavorable outcome [19] .