Pneumonia Severity in Children: Utility of Procalcitonin in Risk Stratification.

OBJECTIVES: To determine if serum procalcitonin, an indicator of bacterial etiology in pneumonia in all ages and a predictor of severe pneumonia in adults, is associated with disease severity in children with community-acquired pneumonia. METHODS: We prospectively enrolled children 2 months to RESULTS: The study included 488 children with pneumonia; 30 (6%) were classified as very severe, 106 (22%) as severe, 327 (67%) as moderate, and 25 (5%) as mild. Median procalcitonin in the very severe group was 5.06 (interquartile range [IQR] 0.90–16.83), 0.38 (IQR 0.11–2.11) in the severe group, 0.29 (IQR 0.09–1.90) in the moderate group, and 0.21 (IQR 0.12–1.2) in the mild group. Increasing procalcitonin was associated with increasing severity (range of aORs: 1.03–1.25) and increased LOS (range of aORs: 1.04–1.36). All comparisons were statistically significant. CONCLUSIONS: Higher procalcitonin was associated with increased severity and LOS. Procalcitonin may be useful in helping clinicians evaluate pneumonia severity.