Higher accuracy of concurrent use of corrected QT interval and procalcitonin serum level to predict sepsis related mortality in ICU patients

Abstract

Background: Sepsis is one of the most serious conditions where early diagnosis is important to decrease mortality. We assessed the use of corrected QT (QTc) interval, and procalcitonin level (PCT) as markers in septicemia to predict the patients' short-term outcome and to get the cut off value of higher diagnostic characteristics. Material and methods: 120 ICU patients with an established diagnosis of septicemia were included. Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score were evaluated for all patients. Patients' co-morbidities, risk factors, laboratory, and hemodynamic records were recorded. QTc was recorded. Also, the PCT level was measured once within the first 24 hours after the diagnosis of sepsis before antibiotic therapy. The patients under study were followed up for the short-term outcome for 14 days to be either survivors or non-survivors. Results: The mean age of our patients was 56.5 ± 6.2 years. The incidence of mortality was 36.7%. SOFA score, APACHE score, PCT level, and prolonged QTc were the parameters that showed a significant difference between the survivor and non-survivor groups. The prolonged QTc showed 70.5% sensitivity and 81.6% specificity to predict mortality. The best cut value of QTc to predict mortality was ≥ 469 ms while for PCT level was 8.4 ng/dl with 75%, 97.7% sensitivity and 81.6%, 57.9% specificity respectively. Conclusion: Prolonged QTc and procalcitonin are easy and available parameters that can be used as markers to predict the ICU patients' mortality with reasonable accuracy.