Cargando…
Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study
BACKGROUND: The diagnostic value of lung ultrasonography (LUS) and procalcitonin (PCT) in the diagnosis of lung infections is known. No studies evaluated the combination of LUS and PCT for the diagnosis of pneumonia in the emergency department (ED). We evaluated the diagnostic accuracy of the combin...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102995/ https://www.ncbi.nlm.nih.gov/pubmed/27830508 http://dx.doi.org/10.1186/s13089-016-0054-8 |
_version_ | 1782466517272625152 |
---|---|
author | Nazerian, Peiman Cerini, Gabriele Vanni, Simone Gigli, Chiara Zanobetti, Maurizio Bartolucci, Maurizio Grifoni, Stefano Volpicelli, Giovanni |
author_facet | Nazerian, Peiman Cerini, Gabriele Vanni, Simone Gigli, Chiara Zanobetti, Maurizio Bartolucci, Maurizio Grifoni, Stefano Volpicelli, Giovanni |
author_sort | Nazerian, Peiman |
collection | PubMed |
description | BACKGROUND: The diagnostic value of lung ultrasonography (LUS) and procalcitonin (PCT) in the diagnosis of lung infections is known. No studies evaluated the combination of LUS and PCT for the diagnosis of pneumonia in the emergency department (ED). We evaluated the diagnostic accuracy of the combination of LUS and PCT in the diagnosis of pneumonia. METHODS: Patients with respiratory symptoms of unexplained origin who underwent a chest CT in ED were included in the study if PCT assay was available. LUS was performed before CT and was targeted to the detection of lung consolidations with the morphologic features of pneumonia. A PCT assay was performed at presentation, and cut-off of 0.25 and of 0.5 ng/ml were used to rule-out and rule-in pneumonia. The final diagnosis of pneumonia was established by independent clinicians, on the basis of clinical chart review including CT results. RESULTS: We enrolled 128 patients and pneumonia was the final diagnosis in 61 (47.7%). In 38 patients (29.7%) LUS and PCT were negative (PCT < 0.25 ng/ml). The overall accuracy, sensitivity and negative predictive value of LUS/PCT were 88.8, 96.7 and 94.7% respectively. Sensitivity of the LUS/PCT test was significantly superior to LUS alone (85.2%) and PCT alone (73.8%) (p < 0.05 for both). Specificity and positive predictive value of the combination of positivity of LUS/PCT (PCT > 0.5 ng/ml) were 94% and 83.3% respectively. Specificity of LUS/PCT was not significantly different to LUS alone (88.1%) (p = 0.125). CONCLUSIONS: The sensitivity of the combination of LUS with PCT for the diagnosis of pneumonia was significantly superior when compared with the sensitivity of LUS and PCT alone. |
format | Online Article Text |
id | pubmed-5102995 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-51029952016-12-02 Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study Nazerian, Peiman Cerini, Gabriele Vanni, Simone Gigli, Chiara Zanobetti, Maurizio Bartolucci, Maurizio Grifoni, Stefano Volpicelli, Giovanni Crit Ultrasound J Original Article BACKGROUND: The diagnostic value of lung ultrasonography (LUS) and procalcitonin (PCT) in the diagnosis of lung infections is known. No studies evaluated the combination of LUS and PCT for the diagnosis of pneumonia in the emergency department (ED). We evaluated the diagnostic accuracy of the combination of LUS and PCT in the diagnosis of pneumonia. METHODS: Patients with respiratory symptoms of unexplained origin who underwent a chest CT in ED were included in the study if PCT assay was available. LUS was performed before CT and was targeted to the detection of lung consolidations with the morphologic features of pneumonia. A PCT assay was performed at presentation, and cut-off of 0.25 and of 0.5 ng/ml were used to rule-out and rule-in pneumonia. The final diagnosis of pneumonia was established by independent clinicians, on the basis of clinical chart review including CT results. RESULTS: We enrolled 128 patients and pneumonia was the final diagnosis in 61 (47.7%). In 38 patients (29.7%) LUS and PCT were negative (PCT < 0.25 ng/ml). The overall accuracy, sensitivity and negative predictive value of LUS/PCT were 88.8, 96.7 and 94.7% respectively. Sensitivity of the LUS/PCT test was significantly superior to LUS alone (85.2%) and PCT alone (73.8%) (p < 0.05 for both). Specificity and positive predictive value of the combination of positivity of LUS/PCT (PCT > 0.5 ng/ml) were 94% and 83.3% respectively. Specificity of LUS/PCT was not significantly different to LUS alone (88.1%) (p = 0.125). CONCLUSIONS: The sensitivity of the combination of LUS with PCT for the diagnosis of pneumonia was significantly superior when compared with the sensitivity of LUS and PCT alone. Springer Milan 2016-11-09 /pmc/articles/PMC5102995/ /pubmed/27830508 http://dx.doi.org/10.1186/s13089-016-0054-8 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Nazerian, Peiman Cerini, Gabriele Vanni, Simone Gigli, Chiara Zanobetti, Maurizio Bartolucci, Maurizio Grifoni, Stefano Volpicelli, Giovanni Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title | Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title_full | Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title_fullStr | Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title_full_unstemmed | Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title_short | Diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
title_sort | diagnostic accuracy of lung ultrasonography combined with procalcitonin for the diagnosis of pneumonia: a pilot study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102995/ https://www.ncbi.nlm.nih.gov/pubmed/27830508 http://dx.doi.org/10.1186/s13089-016-0054-8 |
work_keys_str_mv | AT nazerianpeiman diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT cerinigabriele diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT vannisimone diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT giglichiara diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT zanobettimaurizio diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT bartoluccimaurizio diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT grifonistefano diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy AT volpicelligiovanni diagnosticaccuracyoflungultrasonographycombinedwithprocalcitoninforthediagnosisofpneumoniaapilotstudy |