Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis

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. Pa...

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Main Authors: Mat Nor, Mohd Basri, Md Ralib, Azrina
Format: Article
Language:English
English
Published: Hindawi Publishing Corporation 2014
Subjects:
Online Access:http://irep.iium.edu.my/35857/
http://irep.iium.edu.my/35857/1/35857_Procalcitonin%20clearance%20for%20early%20prediction.pdf
http://irep.iium.edu.my/35857/2/35857_Procalcitonin%20clearance%20for%20early%20prediction_SCOPUS.pdf
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author Mat Nor, Mohd Basri
Md Ralib, Azrina
author_facet Mat Nor, Mohd Basri
Md Ralib, Azrina
author_sort Mat Nor, Mohd Basri
building IIUM Repository
collection Online Access
description 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 non-infectious 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 multi-centre study.
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spelling iium-358572017-09-20T02:44:43Z http://irep.iium.edu.my/35857/ Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis Mat Nor, Mohd Basri Md Ralib, Azrina R Medicine (General) 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 non-infectious 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 multi-centre study. Hindawi Publishing Corporation 2014-02-24 Article PeerReviewed application/pdf en http://irep.iium.edu.my/35857/1/35857_Procalcitonin%20clearance%20for%20early%20prediction.pdf application/pdf en http://irep.iium.edu.my/35857/2/35857_Procalcitonin%20clearance%20for%20early%20prediction_SCOPUS.pdf Mat Nor, Mohd Basri and Md Ralib, Azrina (2014) Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis. Critical Care Research and Practice, 2014 (819034). pp. 1-7. ISSN 2090-1305 http://www.hindawi.com/journals/ccrp/contents/ 819034
spellingShingle R Medicine (General)
Mat Nor, Mohd Basri
Md Ralib, Azrina
Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title_full Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title_fullStr Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title_full_unstemmed Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title_short Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
title_sort procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis
topic R Medicine (General)
url http://irep.iium.edu.my/35857/
http://irep.iium.edu.my/35857/
http://irep.iium.edu.my/35857/
http://irep.iium.edu.my/35857/1/35857_Procalcitonin%20clearance%20for%20early%20prediction.pdf
http://irep.iium.edu.my/35857/2/35857_Procalcitonin%20clearance%20for%20early%20prediction_SCOPUS.pdf