Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients
Objective: High procalcitonin (PCT) and low albumin (ALB) concentrations have been associated with mortality in sepsis. The present study aimed to investigate the prognostic value of PCT to ALB ratio (PCT: ALB) for ICU mortality in septic patients. Methods: This was a registry based retrospective o...
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| Format: | Thesis |
| Language: | English |
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2023
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| Online Access: | http://eprints.usm.my/62761/ http://eprints.usm.my/62761/1/Siti%20Afifah%20Abd%20Manas%20-%20E.pdf |
| _version_ | 1848885081868861440 |
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| author | Manas, Siti Afifah Abd |
| author_facet | Manas, Siti Afifah Abd |
| author_sort | Manas, Siti Afifah Abd |
| building | USM Institutional Repository |
| collection | Online Access |
| description | Objective: High procalcitonin (PCT) and low albumin (ALB) concentrations have been associated with mortality in sepsis. The present study aimed to investigate the prognostic value of PCT to ALB ratio (PCT: ALB) for ICU mortality in septic patients.
Methods: This was a registry based retrospective observational study conducted in the Intensive Care Unit (ICU) of Hospital Universiti Sains Malaysia over a 3-year period. Consecutive adult patients admitted to the ICU who underwent simultaneous measurement of PCT and ALB who fulfilled the Sepsis-3 criteria were recruited. Serum PCT was measured with a point-of-care analyzer available in the ICU (Finecare™ PCT Rapid Test). Predictive performance of PCT: ALB was assessed by analysis of the receiver-operating characteristic (ROC) curve.
Results: A total of 185 sepsis patients were recruited. The primary outcome of all-cause ICU mortality was 35.1%. Baseline PCT was significantly higher while baseline ALB was significantly lower in the non-survivors compared to the survivors [9.8 (IQR 2.64 - 40.65) vs 2.07 (IQR 0.55 – 9.08) ng/mL and 26 (SD = 5) vs 30 (SD = 6) g/L, respectively, P <0.001]. The computed PCT: ALB was significantly higher in the non-survivors compared to the survivors [0.40 (IQR 0.11 – 1.63) vs 0.06 (IQR 0.02 – 0.31), P <0.001]. The area under the ROC curve of PCT: ALB for discrimination of ICU-mortality was 0.731 (95% CI 0.615-0.840) which was higher than PCT alone (AUC 0.721, 95% CI 0.651-0.785). The ideal cut-off value for PCT: ALB was 0.12 with sensitivity of 73.85% and specificity of 60.83%.
Conclusion: PCT: ALB is a potentially reliable tool to aid in the mortality prediction of sepsis although this requires further validation in a prospective multi-center study. |
| first_indexed | 2025-11-15T19:16:56Z |
| format | Thesis |
| id | usm-62761 |
| institution | Universiti Sains Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T19:16:56Z |
| publishDate | 2023 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | usm-627612025-09-02T07:41:33Z http://eprints.usm.my/62761/ Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients Manas, Siti Afifah Abd R Medicine RC31-1245 Internal medicine Objective: High procalcitonin (PCT) and low albumin (ALB) concentrations have been associated with mortality in sepsis. The present study aimed to investigate the prognostic value of PCT to ALB ratio (PCT: ALB) for ICU mortality in septic patients. Methods: This was a registry based retrospective observational study conducted in the Intensive Care Unit (ICU) of Hospital Universiti Sains Malaysia over a 3-year period. Consecutive adult patients admitted to the ICU who underwent simultaneous measurement of PCT and ALB who fulfilled the Sepsis-3 criteria were recruited. Serum PCT was measured with a point-of-care analyzer available in the ICU (Finecare™ PCT Rapid Test). Predictive performance of PCT: ALB was assessed by analysis of the receiver-operating characteristic (ROC) curve. Results: A total of 185 sepsis patients were recruited. The primary outcome of all-cause ICU mortality was 35.1%. Baseline PCT was significantly higher while baseline ALB was significantly lower in the non-survivors compared to the survivors [9.8 (IQR 2.64 - 40.65) vs 2.07 (IQR 0.55 – 9.08) ng/mL and 26 (SD = 5) vs 30 (SD = 6) g/L, respectively, P <0.001]. The computed PCT: ALB was significantly higher in the non-survivors compared to the survivors [0.40 (IQR 0.11 – 1.63) vs 0.06 (IQR 0.02 – 0.31), P <0.001]. The area under the ROC curve of PCT: ALB for discrimination of ICU-mortality was 0.731 (95% CI 0.615-0.840) which was higher than PCT alone (AUC 0.721, 95% CI 0.651-0.785). The ideal cut-off value for PCT: ALB was 0.12 with sensitivity of 73.85% and specificity of 60.83%. Conclusion: PCT: ALB is a potentially reliable tool to aid in the mortality prediction of sepsis although this requires further validation in a prospective multi-center study. 2023 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/62761/1/Siti%20Afifah%20Abd%20Manas%20-%20E.pdf Manas, Siti Afifah Abd (2023) Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients. Masters thesis, Universiti Sains Malaysia. |
| spellingShingle | R Medicine RC31-1245 Internal medicine Manas, Siti Afifah Abd Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title | Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title_full | Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title_fullStr | Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title_full_unstemmed | Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title_short | Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| title_sort | early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients |
| topic | R Medicine RC31-1245 Internal medicine |
| url | http://eprints.usm.my/62761/ http://eprints.usm.my/62761/1/Siti%20Afifah%20Abd%20Manas%20-%20E.pdf |