Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

Poddar, Banani; Gurjar, Mohan; Singh, Sujata; Aggarwal, Amita; Singh, Rekha; Azim, Afzal; Baronia, Arvind Kumar

doi:10.4103/0972-5229.152755

Cited by 28 publications

(13 citation statements)

References 25 publications

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“…In this regard, the assessment of the temporal profile of the two biomarkers concentrations in the first 72 hours after admission has been performed. This analysis showed, in agreement with data reported in the literature [ 27 , 28 ], the utility of PCT in monitoring the evolution of the clinical response to treatment, particularly for the population of patients diagnosed with severe sepsis or septic shock, which present a significantly different trend of serial concentrations when compared to the population of subjects with a diagnosis of sepsis. Copeptin showed a similar behaviour, although not reaching statistical significance a different trend is observed in the group of patients diagnosed with sepsis, suggesting a possible application of copeptin also in monitoring the clinical response to treatment in these populations.…”

Section: Discussionsupporting

confidence: 90%

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Battista¹,

Audisio²,

Galluzzo³

et al. 2016

BioMed Research International

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The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism). Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L), calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment.

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Section: Discussionsupporting

confidence: 90%

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Battista¹,

Audisio²,

Galluzzo³

et al. 2016

BioMed Research International

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“…The PCT is a widely investigated biomarker in sepsis because of the short time between stimulus and PCT induction and its long half-life [ 11 , 12 ]. PCT has high sensitivity and specificity to distinguish sepsis from a systemic inflammatory response syndrome of non-infectious origin, and an elevated PCT level is disclosed to associate with sepsis in hospitalized patients independently [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…When an inflammatory/infection occurs in the individuals, the PCT production process is alternatively and independently triggered by bacterial endotoxin and inflammatory cytokines and takes place in many extrathyroid organs, including liver, lung, kidney, pancreas, brain, heart, and small intestine [ 9 , 10 ]. Under the inflammatory situation, PCT tends to rise rapidly within the first 3–4 hours after the event’s onset, peaks in the 6–12 hours, following a decrease after 24 hours and normalization within five days [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

A novel procalcitonin-based score for detecting sepsis among critically ill patients

Tsui

Huang

et al. 2021

PLoS ONE

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Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

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“…Podder et al . revealed that PCT could change significantly when it was checked serially in sepsis in patients who expired [38]. Zu et al .…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and D-dimer for Predicting 28-Day-Mortality Rate and Sepsis Severity based on SOFA Score; A Cross-sectional Study

Naderpour¹,

Momeni²,

Vahidi³

et al. 2019

BEAT

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Objective:To determine the possible relationship of procalcitonin (PCT) and D-dimer with the 28-day-mortality rate and severity of sepsis based on sequential organ failure assessment (SOFA) score.Methods:In this cross-sectional study, patients were enrolled based on their signs and symptoms of sepsis confirmed by essential laboratory studies. Demographic data, Glasgow coma scale and vital signs, serum PCT and D-dimer levels, creatinine, bilirubin level, arterial blood gas analysis and platelet count were recorded. Disease severity index was assessed based on SOFA score. Patients’ 28-day-mortality rate and hospital length of stay were compared with the study variables.Results:Sixty-four patients with the mean age of 78.3±11.6 were included of whom 34 cases (53.1%) were male. The 28-day-mortality rate was 17%. The analysis showed that only patients’ age (p=0.01) and platelet count (p=0.02) had a statistically significant association with the mortality rate. SOFA score had no statistically significant correlation with PCT or D-dimer; and these two markers didn’t have any significant correlation in terms of predicting mortality due to the sepsis. Conclusion:In our study, PCT and D-dimer failed to show any significant correlation with 28-day-mortality rate of sepsis.

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Procalcitonin kinetics as a prognostic marker in severe sepsis/septic shock

Cited by 28 publications

References 25 publications

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

A novel procalcitonin-based score for detecting sepsis among critically ill patients

Procalcitonin and D-dimer for Predicting 28-Day-Mortality Rate and Sepsis Severity based on SOFA Score; A Cross-sectional Study

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