Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases

Cui, Na; Zhang, Hongwei; Chen, Zhi; Yu, Zhengping

doi:10.1177/0300060518822404

Cited by 68 publications

(65 citation statements)

References 20 publications

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“…Otherwise, CRP is a well-known parameter for diagnosis of sepsis or assessment of predictor of successful antibiotic therapy [18,19]. Recent study indicated that on the 2 nd , 3 rd , and 5 th days, serum CRP level was higher in the nonsurvivor group than in the survivor group, and serum CRP has good clinical prognostic value for patients with sepsis and septic shock [20]. Inconsistently, there was no significant difference in aspect of CRP level on PICU admission between nonsurvivors and survivors in the present study.…”

Section: Mediators Of Inflammationmentioning

confidence: 99%

Fibrinogen as a Prognostic Predictor in Pediatric Patients with Sepsis: A Database Study

Tang

Shao

Dou

et al. 2020

Mediators of Inflammation

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Background. Systemic inflammatory response and vascular endothelial cell injury during sepsis lead to coagulopathy. Fibrinogen has been reported as a biomarker of coagulopathy; however, the prognostic value of fibrinogen remains undefined in pediatric patients with sepsis. The aim of this study was to assess fibrinogen level on pediatric intensive care unit (PICU) admission and to elucidate the relationship between fibrinogen levels and in-hospital mortality in children with sepsis. Methods. We conducted a database study. The sepsis database was divided into a training set (between July 2014 and June 2018) and a validation set (from July 2018 to June 2019). The clinical and laboratory parameters on PICU admission and in-hospital mortality in sepsis database were collected and analyzed. Results. A total of 819 pediatric patients were included from database as a training set. The overall hospital mortality was 12.1% (99/819). The fibrinogen levels were significantly lower in nonsurvivors than survivors. Multivariate logistic regression analysis showed significant associations between fibrinogen, lactate level, and hospital mortality (fibrinogen: odds ratio (OR), 0.767 (95% CI: 0.628-0.937), P=0.009; lactate: OR, 1.346 (95% CI: 1.217-1.489), P<0.001, respectively), which was confirmed in a validation set (0.616 [95% CI: 0.457-0.829], P=0.001; 1.397 [95% CI: 1.245-1.569], P<0.001, respectively). The hospital mortality of patients with fibrinogen<1 g/L, 1-2 g/L, 2-3 g/L, or over 3 g/L displayed an obvious difference (62.5% vs. 27.66% vs. 18.1% vs. 4.2%, respectively). Furthermore, the area under the receiver operating characteristic curve (ROC) for fibrinogen in predicting hospital mortality was 0.780 (95% CI: 0.711-0.850) in pediatric patients with sepsis. Conclusions. Fibrinogen is a valuable prognostic biomarker for pediatric sepsis. The level of fibrinogen lower than 2 g/L on PICU admission is closely related to the greater risk of hospital death in pediatric sepsis.

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Section: Mediators Of Inflammationmentioning

confidence: 99%

Fibrinogen as a Prognostic Predictor in Pediatric Patients with Sepsis: A Database Study

Tang

Shao

Dou

et al. 2020

Mediators of Inflammation

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“…Several common inflammation biomarkers including c-reactive protein, procalcitonin, and white blood cell count have shown prognostic values on sepsis. 3,4 Early identification of those who are in danger of adverse outcomes might be conducive to prompt and adequate treatments of sepsis. 5 Complete blood count (CBC) is one of the most common and inexpensive laboratory tests in the hospital.…”

Section: Introductionmentioning

confidence: 99%

<p>The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study</p>

Ge¹,

Lin²,

Zhang³

et al. 2020

TCRM

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Background: Sepsis is a life-threatening and inflammatory disease with high morbidity and mortality. Red blood cell distribution width to platelet count ratio (RPR) was known as an inflammatory biomarker and was related to poor outcomes of various diseases. Aim: This study was intended to explore the association between RPR and mortality of sepsis patients. Methods: A retrospective cohort study was undertaken in patients with sepsis, and the data were collected from a public database called Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was 28-day mortality while the secondary outcomes were 90-day mortality and ICU mortality. Multivariable regression analyses, as well as interaction and stratified analyses, were conducted to investigate the relation between RPR and sepsis mortality. Results: In total, we enrolled 7531 patients with 1316 deaths. RPR was independently correlated with 28-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.02-1.06), 90-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.03-1.06) and ICU mortality (per 0.1 increase: OR=1.06; 95% CI 1.02-1.10). Twenty-eight-day survival was worse in the high RPR (≥0.134) group according to the Kaplan-Meier curve analyses (Log rank test, p<0.001). In stratified analyses, Sequential Organ Failure Assessment (SOFA) score and length of ICU stay had interactive effects with the high RPR (≥0.134) group on 28-day mortality. Conclusion: RPR is a novel biomarker that indicates poor prognosis of sepsis patients. Clinicians are required to pay more attention to those patients with high RPR.

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“…Serum PCT and CRP have good clinical diagnosis and prognostic value for patients with sepsis and septic shock. Kinetic studies of PCT and CRP may increase sensitivity and accuracy when evaluating the prognosis of patients with sepsis and septic shock [28]. They have been used for early detection of infection and directing antibiotic therapy [8].…”

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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Purpose: To investigate the combination of serum C-reactive protein (CRP) and procalcitonin (PCT) kinetics in predicting mortality in nosocomial blood stream infections (BSIs).Materials and Methods: We retrospectively reviewed the medical records of patients ≥ 18 years of age with nosocomial BSIs hospitalized in intensive care units (ICU). Clinical, microbiological and biochemical data were compared in patients who survivors and deaths. Binary logistic regression analyses were used to identify independent risk factors. The kinetic changes were defined the as difference between level on 5th day and level at 1st day of BSI.Results: Of the 84 included patients, 49 (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), 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. In the logistic regression analysis, APACHE-II score (OR=1.46, 95% 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%C = 4.52-299.01, p=0.001) were independent predictors of 28-day mortality.Conclusions: The ∆PCR kinetic was a strong independent predictor of mortality in nosocomial BSIs in ICUs.

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Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases

Cited by 68 publications

References 20 publications

Fibrinogen as a Prognostic Predictor in Pediatric Patients with Sepsis: A Database Study

Fibrinogen as a Prognostic Predictor in Pediatric Patients with Sepsis: A Database Study

<p>The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study</p>

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

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