Procalcitonin Levels as an Early Marker in Patients with Multiple Trauma under Intensive Care

Balcı, Canan; Sivaci, Remziye; Akbulut, Gamze; Karabekir, HS

doi:10.1177/147323000903700606

Cited by 39 publications

(45 citation statements)

References 24 publications

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“…PCT levels are closely related to the severity and evolution of infection, and they are thought to be associated with poor prognosis in patients with septicaemia [12,13]. PCT has been used to evaluate the evolution of infections and sepsis in patients with trauma and surgical conditions [5,14,15]. The changes of PCT level in response to therapeutic treatment have also been reported, which suggests prognostic significance in a variety of clinical settings [16,17].…”

Section: Introductionmentioning

confidence: 99%

Procalcitonin as a marker of sepsis and outcome in patients with neurotrauma: an observation study

et al. 2013

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BackgroundProcalcitonin (PCT) is a reliable biomarker of sepsis and infection. The level of PCT associated with sepsis and infection in patients with traumatic brain injury is currently unknown. The purpose of this study was to investigate the value of PCT and C-reactive protein (CRP) as diagnostic markers of sepsis and to evaluate the prognostic value of these markers related to the severity of injury, sepsis and mortality.Methods105 adult patients with neurotrauma were enrolled in this study from June 2011 to February 2013. PCT and CRP were measured at admission and 2, 3, 5 and 7 days after admission. The sepsis criteria established by American College of Chest Physicians /Society of Critical Care Medicine Consensus Conference were used to identify patients. Injury Severity Score (ISS) and Glasgow Coma Score (GCS) were used to assess the severity of the injury. All these patients were monitored for 28 days.ResultsAt admission, the median level of PCT was consistent with the severity of brain injury as follows: mild 0.08 ng/ml (0.05 - 0.13), moderate 0.25 ng/ml (0.11 - 0.55) and severe 0.31 ng/ml (0.17 - 0.79), but the range of CRP levels varied greatly within the given severity of brain injury. Seventy-one (67.6%) patients developed sepsis. The initial levels of PCT at admission were statistically higher in patients with sepsis, compared with patients with systemic inflammatory response syndrome (SIRS), but there were no differences in the initial concentration of CRP between sepsis and SIRS. After adjusting for these parameters, multivariate logistic regression analysis revealed that PCT was an independent risk factor for septic complications (p < 0.05). The areas under the ROCs at admission for the prediction of mortality were 0.76 (p < 0.05) and 0.733 for PCT and CRP, respectively.ConclusionsIncreased levels of PCT during the course of the ICU stay could be an important indicator for the early diagnosis of sepsis after neurotrauma. In addition, high serum levels of PCT in patients with neurotrauma at admission indicate an increased risk of septic complications, and the daily measurement of PCT assists in guiding antibiotic therapy in neurotrauma patients.

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Section: Introductionmentioning

confidence: 99%

Procalcitonin as a marker of sepsis and outcome in patients with neurotrauma: an observation study

et al. 2013

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“…Septic patients have increased or low temperature (> 38°C or < 36°C) and leukocytes counts > 12×10 9 /L or < 4×10 9 /L. They can have tachycardia and rapid breathing [13,14]. Time to diagnosis and introduction of empirical antibiotic therapy are crucial [15].…”

Section: Introductionmentioning

confidence: 99%

CD64 index on neutrophils can diagnose sepsis and predict 30-day survival in subjects after ventilator-associated pneumonia

Muzlovič

Ihan

Stubljar

2016

J Infect Dev Ctries

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Introduction: Sepsis associated with ventilator-associated pneumonia (VAP) causes mortality in intensive care unit (ICU) patients. The time of diagnosis is crucial, and microbiological cultures take time. In this study, the diagnostic accuracy of CD64 index to predict VAP-induced sepsis and survival time in subjects requiring mechanical ventilation were evaluated and compared to conventional biomarkers and culturing methods. Methodology: A total of 32 subjects with VAP were included. Sepsis after VAP was diagnosed in 25 (78.1%) patients according to clinical signs, radiographic examination, and samples of blood and trachea taken for culturing. Simultaneously with cultures, CD64 index on neutrophils, C-reactive protein (CRP), procalcitonin (PCT), and count of leucocytes and neutrophils were determined. Results: Biomarker values were evaluated in both groups of subjects (with and without sepsis after VAP). The values of CD64 index and CRP were significantly higher in the sepsis group. Receiver operating characteristic (ROC) curve analysis revealed an area under curve (AUC) of 0.929 for CD64 index in differentiating subjects with VAP-induced sepsis from those without sepsis. The biomarkers CRP and PCT showed comparable results (AUC of 0.869 and 0.909, respectively). Blood cultures were positive in 12 subjects, endotracheal aspirate in 19. CD64 index and isolation of pathogen with positive blood cultures or from endotracheal aspirate (positive in 24 cases) could predict survival time before application of more targeted antibiotic therapy. Conclusions: CD64 index may be used as a useful diagnostic tool to recognize VAP-induced sepsis; moreover, accompanied with an identified pathogen, can predict survival for ICU patients.

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“…[4] Continuous high levels or secondary increases of PCT are predictors of sepsis. [27,28,30–34] PCT as a biomarker is useful in the prediction and early diagnosis of sepsis in trauma patients. Currently, PCT is already used in clinical practice, and it is used to guide antibiotic therapy in patients with lower respiratory tract infections or other infections such as fungal infections, postoperative fever and suspected bloodstream infections.…”

Section: Biomarkersmentioning

confidence: 99%

“…Both prospective studies and retrospective studies have reported no predictive power of CRP for sepsis in trauma patients. [4,28,30–32,40–43]…”

Section: Biomarkersmentioning

confidence: 99%

Prediction of sepsis in trauma patients

Liu

Xiao

et al. 2014

Burn Trauma

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Trauma is one of the leading causes of death worldwide. Approximately 39.5% of deaths occur in the hospital, and the mortality rate of delayed death caused by septic complications is still high. Early prediction of the development of sepsis can help promote early intervention and treatment for patients and contribute to improving patient outcomes. Thus so far, biomarkers, patient demographics and injury characteristics are the main methods used for predicting sepsis in trauma patients. However, studies that verify their predictive value are limited, and the results are still controversial. More work should be conducted to explore more efficient and accurate ways to predict post-traumatic sepsis.

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Procalcitonin Levels as an Early Marker in Patients with Multiple Trauma under Intensive Care

Cited by 39 publications

References 24 publications

Procalcitonin as a marker of sepsis and outcome in patients with neurotrauma: an observation study

Procalcitonin as a marker of sepsis and outcome in patients with neurotrauma: an observation study

CD64 index on neutrophils can diagnose sepsis and predict 30-day survival in subjects after ventilator-associated pneumonia

Prediction of sepsis in trauma patients

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