Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis

Abstract

BackgroundTo investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis.Material/MethodsA total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson’s correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients’ death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis.ResultsThe expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson’s correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77–0.88), 0.76 (95% CI, 0.70–0.82), and 0.73 (95% CI, 0.67–0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87–0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001).ConclusionsThe combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.

Early lactate measurements for predictingin‐hospitalmortality in paediatric sepsis

“…High-sensitivity C-reactive protein (hs-CRP), a key inflammatory cytokine, has been found to be an early marker of sepsis severity and poor prognosis in a few studies in children with sepsis. 25 We performed a dynamic assessment of hs-CRP and found that nonsurvivors persisted to have high hs-CRP. The strengths of our study include its practical applicability in the emergency settings rather than ICUs, which are often scant in resource poor countries.…”

Aspartate transaminase/alanine transaminase ratio as a significant prognostic factor in patients with sepsis: a retrospective analysis

“…Considering the large population in China, sepsis will be a great threat to people's life and a heavy burden on the health care system. Therefore, early identi cation and timely prevention will undoubtedly improve the prognosis of patients with sepsis [41] Researches showed that multiple factors, including patient admission scores, patients comorbid disease and demographic indicators like age, gender, race, were capable of affecting the prognosis of patients with sepsis, accompanied by numerous laboratory indexes such as neutrophil to lymphocyte ratio, platelet, albumin, procalcitonin, C-reactive protein, creatinine, urea nitrogen and lactate [38,39,[42][43][44][45][46][47] . Continuous monitoring of these indicators is conducive to early identi cation and timely treatment of septic patients.…”

Monitoring Antibiotics and Inflammatory Markers in Human Blood: Impact in Choice of Antibiotic Therapy and Used Methods

“…Sepsis is one of the main causes of death in patients after ineffective and untimely antibiotic therapy, fulminant infections, superinfection, inadequate diagnosis of the patient's condition, risky surgeries performed in violation of asepsis standards, or the appearance and spreading of a wound infection [2]. The generalization of the process, resulting in the disruption of the biochemical functions of vital organs and the appearance of local foci of inflammation, leads ultimately to the inability of the organism to fight bacterial infection, leading to severe septicemia, intoxication of the organism with the decay products of pathogens and its own tissues, septic shock and multi-organ failure [38]. A schematic representation of the mechanism is shown in Figure 2.…”

“…For example, Miglietta et al [44] showed that procalcitonin is found in high concentrations in the blood at the early stages of sepsis, and its content only decreases after intensive antibiotic therapy. The work of Wu et al demonstrated the prognostic role of procalcitonin, since high levels of this marker were subsequently associated with the death of patients, while, in the surviving group, its content in the blood was lower [38]. However, the decisive factor in choosing this marker as an indicator of the presence of septic process due to bacterial infection is its important distinguishing feature-unlike other markers of inflammation, procalcitonin level never rises if the infection process has a viral etiology [45].…”

“…At the present, a concentration of 0.4 ng/mL is chosen as a cut-off level to distinguish between positive and negative samples in laboratory diagnostics. This parameter is most often assessed in cases of suspected secondary infection, in order to understand its etiology in patients with immunodeficiency, including undergoing antibiotic therapy, after surgery, during sepsis monitoring, or suffering from multiple organ failure [38,50].…”