{
  "abstract": "Background/objectives: Pneumonia frequently precipitates AECOPD, and procalcitonin (PCT) has been utilized to guide antibiotic administration in these patients. However, the specific role and clinical significance of PCT in AECOPD patients who do not have pneumonia remains unexplored and is yet to be thoroughly evaluated.\n\nMethods: We conducted univariate and multivariate cox regression analyses to identify independent risk factors for in-hospital mortality among AECOPD patients. The Youden index was applied to determine the optimal cutoff value for PCT, which was then used to categorize participants into two groups based on this threshold. Subsequently, we compared the clinical manifestations and outcomes of patients between these groups, and Kaplan–Meier curves were con-structed and analyzed using the log-rank test. A subgroup analysis was also conducted in patients with/without antibiotic using during hospitalization.\n\nResults: A total of 6,791 hospitalized AECOPD patients of 10 tertiary care hospitals within China was enrolled in our study from September 2017 to July 2021. Univariable and multivariable cox regression analyses revealed that PCT (HR 1.016, 95% CI 1.003–1.029, p = 0.014) as independent risk factors for in-hospital mortality in AECOPD patients. The ROC analysis established an optimal cut-off value of 0.11 for predicting in-hospital mortality. The PCT high group (≥0.11 ng/mL) demonstrated higher proportion of chronic underlying diseases, and higher age-adjusted Charlson comorbidity index score, increased in-hospital mortality, greater ICU admission rates, higher rates of invasive mechanical ventilation, and a longer length of stay (all P < 0.001). PCT and the cut-off value of 0.11 could also have effective prognostic value in both subgroups of patients with/without antibiotic usage.\n\nConclusions: PCT emerged as an independent risk factor for in-hospital mortality in AECOPD patients without pneumonia. Those with elevated PCT levels (≥0.11 ng/mL) exhibited a higher burden of comorbidities, a potential of pro-infection or pro-inflammation and poorer clinical outcomes.\n\nClinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=12162, identifier ChiCTR2100044625.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University , , ,",
    "Center of Infectious Diseases, Division of Infectious Diseases in State Key Laboratory of Biotherapy, West China Hospital, Sichuan University , , ,",
    "State Key Laboratory of Respiratory Disease, Guangzhou Medical University , , ,",
    "Department of Respiratory and Critical Care Medicine, People’s Hospital of Leshan , , ,",
    "Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , , ,",
    "Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , , ,",
    "Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , , ,",
    "Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Neijiang City , , ,",
    "Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University , , ,",
    "Department of Emergency, First People's Hospital of Jiujiang , , ,",
    "Sichuan Cancer Hospital, University of Electronic Science and Technology of China , , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Min Qi"
    },
    {
      "affs": [
        1
      ],
      "name": "Chen Zhou"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuanming Luo"
    },
    {
      "affs": [
        3
      ],
      "name": "Hailong Wei"
    },
    {
      "affs": [
        4
      ],
      "name": "Huiqing Ge"
    },
    {
      "affs": [
        5
      ],
      "name": "Huiguo Liu"
    },
    {
      "affs": [
        6
      ],
      "name": "Jianchu Zhang"
    },
    {
      "affs": [
        7
      ],
      "name": "Xianhua Li"
    },
    {
      "affs": [
        8
      ],
      "name": "Pinhua Pan"
    },
    {
      "affs": [
        7
      ],
      "name": "Xiufang Xie"
    },
    {
      "affs": [
        9
      ],
      "name": "Mengqiu Yi"
    },
    {
      "affs": [
        9
      ],
      "name": "Lina Cheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiarui Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Lige Peng"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiaqi Pu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xueqing Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Haixia Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongjiang Tang"
    },
    {
      "affs": [
        10
      ],
      "name": "Qun Yi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/74m1vcfn96z2k.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1905875",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727543/?tool=EBI",
  "id": "74m1vcfn96z2k",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727543",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7223012834",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727543/pdf/?tool=EBI",
  "pmcid": "PMC13727543",
  "pmid": "42978763",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/74m1vcfn96z2k.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13727543",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727543"
    },
    {
      "first_seen": "2026-11-06T12:23:24Z",
      "native_id": "PMC13727543",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1905875"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "Procalcitonin as a prognostic factor in patients with acute exacerbation of COPD without pneumonia: a prospective multicenter cohort study",
  "title_text": "Procalcitonin as a prognostic factor in patients with acute exacerbation of COPD without pneumonia: a prospective multicenter cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:42Z",
  "url": "https://research.draconitic.com/paper/74m1vcfn96z2k",
  "venue": "Frontiers in medicine",
  "versions": []
}