Clinical significance of the detection of procalcitonin and C-reactive protein in the intensive care unit

Li, Qinhao; Gong, Xiao-Na

doi:10.3892/etm.2018.5960

Cited by 20 publications

(20 citation statements)

References 23 publications

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“…CRP kinetics has recently been studied to evaluate response and prognosis in patients in the ICU. 23 Our results suggest that there is no association between the CRP kinetics pattern and both early and late mortality. In the past, several studies have suggested CRP serum levels as a mortality predictor.…”

Section: Discussionmentioning

confidence: 56%

Usefulness of Early C-Reactive Protein Kinetics in Response and Prognostic Assessment in Infected Critically Ill Patients: An Observational Retrospective Study

et al. 2019

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Introduction: The ideal biomarker to assess response and prognostic assessment in the infected critically ill patient is still not available. The aims of our study were to analyze the association between early C-reactive protein kinetics and duration and appropriateness of antibiotic therapy and its usefulness in predicting mortality in infected critically ill patients. Material and Methods:We have carried out an observational retrospective study in a cohort of 60 patients with community-acquired pneumonia, aspiration pneumonia and bacteremia at an intensive care unit. We have collected C-reactive protein consecutive serum levels for eight days as well as duration and appropriateness of initial antibiotic therapy. C-reactive protein kinetic groups were defined based on the levels at days 0, 4 and 7. With a follow-up of one year, we have evaluated mortality at different time-points. Results:We have obtained three different C-reactive protein kinetic groups from the sample: fast response, delayed but fast response and delayed and slow response. We did not find statistically significant associations between C-reactive protein kinetics and early (intensive care unit, hospital and 28-days) or late (six months and one year) mortality and antibiotic therapy duration (p > 0.05). Although there were no statistically significant differences between the appropriateness of antibiotic therapy and the defined groups (p = 0.265), no patient with inappropriate antibiotic therapy presented a fast response pattern.Discussion: Several studies suggest the importance of this protein in infection. Conclusion: Early C-reactive protein kinetics is not associated with response and prognostic assessment in infected critically ill patients. Nevertheless, a fast response pattern tends to exclude initial inappropriate antibiotic therapy. RESUMOIntrodução: O biomarcador ideal capaz de avaliar a resposta e prognóstico no doente crítico infetado ainda não está disponível. Os objetivos do nosso estudo foram avaliar a relação da cinética precoce da proteína C-reativa com a duração e apropriação da terapêutica antibiótica e a sua utilidade na predição de mortalidade. Material e Métodos:Realizámos um estudo retrospetivo observacional numa coorte de 60 doentes com pneumonia adquirida na comunidade, pneumonia de aspiração e bacteremia numa unidade de cuidados intensivos. Colhemos níveis séricos de proteína C-reativa durante oito dias e a duração e apropriação da terapêutica antibiótica inicial. Definimos grupos de cinética de proteína C-reativa com base nos níveis dos dias 0, 4 e 7. Durante um ano de seguimento, analisámos a mortalidade em diferentes momentos.Resultados: Da amostra obtivemos três grupos de cinética de proteína C-reativa: resposta rápida, resposta atrasada mas rápida e resposta atrasada e lenta. Não observamos associação estatisticamente significativa entre a cinética da proteína C-reativa com a mortalidade precoce (unidade de cuidados intensivos, hospital e aos 28 dias) ou tardia (seis meses e um ano) e duração da terapêutica antibió...

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Section: Discussionmentioning

confidence: 56%

Usefulness of Early C-Reactive Protein Kinetics in Response and Prognostic Assessment in Infected Critically Ill Patients: An Observational Retrospective Study

et al. 2019

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“…The levels of PCT, CRP and SAA have important clinical significance in the diagnosis and treatment of Sepsis and other infectious diseases. 5 - 10 …”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis

2020

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Objectives: To investigate the clinical application values of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum amyloid A (SAA) in the early diagnosis of sepsis. Methods: In this retrospective analysis, 36 patients admitted to Liaocheng People’s Hospital were selected from May 2018 to July 2019. According to infectious disease diagnostic criteria, 17 patients were confirmed to have sepsis (observation group), and 19 patients were determined to be nonseptic (control group). The levels of PCT, CRP and SAA of patients were detected on admission, and the clinical application values of PCT, CRP and SAA for sepsis were compared. Results: Seventeen patients were included in the observation group, including 9 males and 8 females, with an average age of 52.18 ± 9.49 years; 19 patients were included in the control group, including 12 males and 7 females, with an average age of 51.53 ± 8.50 years. On admission, there were significant differences in white blood cell (WBC) count (t = 5.134), neutrophil count (t = 3.143), lymphocyte count (t = 2.510), PCT (t = 9.250), hs-CRP (t = 2.947) and SAA (t = 11.360) between the observation group and the control group, and the differences were statistically significant. For the comparison of clinical application values: the sensitivity of PCT, hs-CRP and SAA was 78.95%, 52.17% and 50.00%, respectively; the specificity of PCT, hs-CRP and SAA was 88.24%, 61.54% and 37.50%, respectively; the area under the ROC curve (AUC) of PCT, hs-CRP and SAA was 0.920, 0.684 and 0.870, respectively; the logistic regression coefficient of PCT, hs-CRP and SAA was -0.577, -0.028 and -0.009, respectively; and the 95% confidence interval (CI) of PCT, hs-CRP and SAA was 0.779-0.985, 0.508-0.828 and 0.716-0.958, respectively. Conclusion: Compared with hs-CRP and SAA, PCT had a higher clinical application value for sepsis, and PCT could be used as a reliable index for the early diagnosis of sepsis. doi: https://doi.org/10.12669/pjms.36.7.2544 How to cite this:Sui Y, Xin W, Feng L. Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2544 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Initial CRP and PCT cannot be considered useful markers in patients with acute and chronic conditions [8]. In recent studies, different results have been observed on the relationship of PCT and CRP levels with mortality [30,31]. CRP and PCT kinetics in the rst days were associated with use of appropriate (active) empirical therapy [26,32].…”

Section: Discussionmentioning

confidence: 99%

The impact of procalcitonin to C-reactive protein ratio (PCR) kinetics as a predictor of mortality in nosocomial bloodstream infections

Hakyemez

Aslan

Durdu

2020

Preprint

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Background: This study was performed to investigate the combination of serum C-reactive protein (CRP) and procalcitonin (PCT) kinetics as a best marker in predicting mortality in patients with nosocomial blood stream infection (BSI).Methods: We retrospectively reviewed the medical records of patients ≥ 18 years of age with nosocomial BSIs hospitalized in intensive care units during the period from January 2016 to June 2018. Eighty-four patients who met the inclusion criteria were included in the study. Clinical, microbiological and biochemical data were compared in patients who survivors and deaths. Binary logistic regression analyses (backward LR) were used to identify independent risk factors. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive accuracy. The kinetic changes were expressed as Δ (delta) and defined the as difference between level on day 5 and level at day 1 of BSI.Results: Of the 84 included patients, 46 (58.4%) had survivors and 35 (41.6%) had deaths. In univariate analysis, renal disease (p = 0.007), cardiac disease (p = 0.042), septic shock (p = <0.001), maximum SOFA (p = <0.001) and APACHE-II (p <0.001), ΔCRP (p = 0.004), ΔPCT (p = <0.001), and ΔPCR (p = 0.025) were significantly higher in non-survivors than in survivors. In the logistic regression analysis, APACHE-II score (odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.20-1.78, p <0.001), ΔCRP (OR = 1.18, %95 CI =1.04-1.34, p = 0.009), ΔPCT (OR = 0.87, 95% CI = 0.79-0.95, p = 0.001), and ∆PCR (OR = 36.78, 95% CI = 4.52-299.01, p = 0.001) were independent predictors of 28-day mortality. After a ROC analysis, the AUC of ∆PCR was higher than that of ∆PCT for mortality in ICU patients (0.745 vs. 0.712, p <0.001).Conclusions: The PCR kinetic was a strong independent predictor of mortality in patients with nosocomial BSIs in intensive care units. Especially in patients with CRP and PCT tested together, it is expected to be a fast and rational tool for clinical practice.

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Clinical significance of the detection of procalcitonin and C-reactive protein in the intensive care unit

Cited by 20 publications

References 23 publications

Usefulness of Early C-Reactive Protein Kinetics in Response and Prognostic Assessment in Infected Critically Ill Patients: An Observational Retrospective Study

Usefulness of Early C-Reactive Protein Kinetics in Response and Prognostic Assessment in Infected Critically Ill Patients: An Observational Retrospective Study

Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis

The impact of procalcitonin to C-reactive protein ratio (PCR) kinetics as a predictor of mortality in nosocomial bloodstream infections

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