Procalcitonin as a prognostic marker for sepsis: a prospective observational study

Abstract

BackgroundProcalcitonin is useful for the diagnosis of sepsis but its prognostic value regarding mortality is unclear. This prospective observational study was designed to study the prognostic value of procalcitonin in prediction of 28 day mortality in patients of sepsis. Fifty-four consecutive patients of sepsis, severe sepsis and septic shock defined using the 2001 Consensus Conference SCCM/ESICM/ACCP/ATS/SIS criteria from medical Intensive Care Unit (ICU) of a tertiary care center in New Delhi, India were enrolled from July 2011 to June 2013. Procalcitonin (PCT), C-reactive protein (CRP) measurements were recorded on day 1, day 7 and day 28 of follow up.ResultsProcalcitonin value was a better predictor of all-cause short-term mortality than C-reactive protein. Those patients with Procalcitonin levels <7 ng/ml showed higher cumulative survival than those with level [greater than or equal to]7 ng/ml (69.1% vs. 39.5%, p = 0.02). No such effect was observed in relation to C-reactive protein. Procalcitonin levels [greater than or equal to]7 ng/ml predicted mortality with a hazard ratio of 2.6(1.1-6.3).ConclusionsA Procalcitonin value [greater than or equal to]7 ng/ml obtained at the time of admission to the ICU is a predictor of short-term mortality and thus may allow the identification of those septic patients at increased mortality risk, and help improve their treatment.

Usefulness of several biomarkers in the management of septic patients: C-reactive protein, procalcitonin, presepsin and mid-regional pro-adrenomedullin

“…When we are talking about sepsis we do not distinguish between SS or SSh in patients [19]. We failed to detect any prognostic value of PCT, CRP and presepsin in our study, even though some authors pointed it out [18,[20][21][22]. Interestingly, MR-proADM showed a relevant prognostic value especially in SSh patients, and also improved the prognostic value of the APACHE-II score when they were used together.…”

“…A large number of studies support the relevant role of PCT as biomarker for the diagnosis of sepsis [12][13][14][15][16][17][18][19]. We would Brought to you by | Carleton University OCUL Authenticated Download Date | 6/22/15 10:29 PM like to contribute through the comparison of PCT with three biomarkers, the well known CRP and the relatively recent presepsin and MR-proADM, in ICU patients regardless of the affected organ that was the origin of sepsis.…”

“…This could be due to the fact that our study was conducted exclusively in patients admitted in the ICU service that met criteria of SS or SSh according to the Surviving Sepsis Campaign [1], the case/control design that considered as controls, non-septic patients from the same ICU [12,13,17,18], and also to the fact that for evaluating the diagnostic efficiency of SSh and SS we used as gold standard the discharge report to confirm the pathology both in cases and controls. However, a recent article review the sepsis definitions because the possible interchangeably concepts of sepsis and SS.…”

Análisis de la asociación entre procalcitonina y mortalidad por sepsis en menores de 18 años en una unidad de cuidados intensivos, Pasto- Colombia 2012 - 2014

“…Los reportes de prevalencia de sepsis y letalidad por sepsis coincidieron con los valores reportados en otras unidades de cuidado crítico, en donde se muestran cifras de 23% a 52% para la prevalencia y de 18% a 56% para la letalidad (27)(28)(29) . De esta manera y teniendo en cuenta el análisis bivariado se evidenció que los valores altos de procalcitonina (mayores de 10 ng/ml) en los pacientes con sepsis se relacionan con muerte, sin embargo, no se debe dejar de considerar algunas covariables que pudieran influir en la muerte.…”

“…Sin embargo, no hay suficiente evidencia que establezca que la procalcitonina predice la sobrevida en población infantil (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) . Este estudio pretende determinar si existe relación entre valores de procalcitonina y la muerte en niños con sepsis que ingresan a la unidad de cuidado intensivo pediátrico (UCIP).…”