Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

Abstract EN

Introduction.

Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established.

We evaluated the prognostic value of dynamic changes of PCT in sepsis patients.

Methods.

A prospective observational study was conducted in adult ICU.

Patients with systemic inflammatory response syndrome (SIRS) were recruited.

Daily PCT were measured for 3 days.

48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT.

Results.

95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS).

40% patients in the sepsis group died in hospital.

Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality.

In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)).

Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)).

Conclusions.

PCTc-48 is associated with prediction of survival in critically ill patients with sepsis.

This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding.

This would benefit from replication in future multicentre study.