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

Study Overview
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Brief Summary
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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
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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.

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

Conditions
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Pneumonia

Intervention / Treatment
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* Diagnostic Test: Procalcitonin lab test


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Procalcitonin lab test<br>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. | Diagnostic Test: Procalcitonin lab test<br>* A procalcitonin order bundle will be created for admitted patients with pneumonia. This prepopulated bundle includes an initial and 24 hour procalcitonin level.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Procalcitonin level | Change in procalcitonin level in the blood serum | Measured at baseline and at 24 hours | 

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Serial Procalcitonin, Admitted Pneumonia, qSOFA, Sepsis