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Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. One of the most important events in the course of COPD is acute exacerbation. Acute exacerbation of COPD (AECOPD) is characterized by the aggravation of dyspnea, cough, and sputum. Chronic obstructive pulmonary disease exacerbation leads to respiratory failure, hospitalization, morbidity, and mortality. During and after the COPD attack, lung function dramatically decreased. Bacterial pneumonia is an important and serious risk factor for AECOPD. However, there are other inflammatory and non-inflammatory causes of AECOPD. Antibiotic treatment is usually challenging in AECOPD. Procalcitonin is a non-hormone active protein and precursor to calcitonin that consists of 116 amino acids, and 13 kDa weight is produced by the neuroendocrine cells of the thyroid gland. However, procalcitonin is secreted in septic shock, metastatic cancers, bacterial and fungal infections; therefore, serum procalcitonin is increased in bacterial pneumonia of AECOPD. Some studies recommended procalcitonin serum measurement as a guide for antibiotic initiation in AECOPD. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) is a disease of chronic diffuse irreversible airflow obstruction. Due to the relatively high prevalence of the disease, paying attention to the treatment of these patients helps a lot in controlling the disease and reducing its cost. This study aimed to investigate the presence of serum procalcitonin in patients with an acute attack of COPD. Methods & Materials: This cross-sectional study was performed on 65 patients with an acute COPD attack in Imam Reza Hospital in 2019 by the convenience sampling method. Three ccs of blood samples were taken from patients to check serum procalcitonin levels from hospitalization to 24 hours after that. Patients with an acute COPD attack were selected based on American thoracic society criteria. Also, demographic information such as age, sex, hospitalization time, and duration of the disease was recorded. Patient complaints, disease exacerbation, and type of ventilation were recorded. Data were analyzed with SPSS software (version 16). Man-Whitney and Kruskal Wallis tests were used to analyze the data. The signi@icance level was <0.05. Informed consent was received from all participants. Results: According to data, 65 patients (36 men and 29 women) were examined and the mean age of the patients was 66.72 (±12.65) years. Dyspnea was the most common complaint in patients. Serum procalcitonin levels were higher in patients with invasive ventilation (P = 0.007). Also, serum procalcitonin levels were lower in patients with non-invasive ventilation (P = 0.008). Besides, serum procalcitonin levels increase with increasing disease exacerbation from mild to moderate (P <0.001). According to the results of the post hoc test, there was a signi@icant difference between mild and severe (P <0.001) and moderate and severe groups (P <0.001). There is also a signi@icant correlation between procalcitonin serum levels and exacerbation (R=0.6, P <0.001) and age (R=0.2, P = 0.01). serum procalcitonin levels were higher in patients with the use of invasive ventilation. Conclusion: According to the results, serum procalcitonin levels are associated with acute COPD attacks. Measurement of procalcitonin levels in patients with acute COPD attacks can help diagnose and perform timely care. [ABSTRACT FROM AUTHOR]