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

Abstract

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.

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

“…Changes in PCT levels in response to therapeutic treatment have also been reported, which suggests a prognostic significance in a variety of clinical settings [35,36,37,38]; however, in this study PCT 2 measurements and changes in PCT levels did not have any significance in predicting death. This might be for the following reasons: (1) only 51 patients had a PCT 2 measurement, and (2) the percentage of inappropriate antibiotic therapies was relatively low (15.8%).…”

Plasma Neutrophil Gelatinase‐Associated Lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis

“…Finally, we only analyzed day 1 plasma NGAL concentration. Of interest is how the dynamic of NGAL changes as a tool of mortality prediction, as we have shown previously that a single measurement of procalcitonin was not predictive; however, its dynamic concentration over 3 days was predictive A further analysis looking at the dynamic of NGAL over several days for prediction of mortality in survival prediction may be of interest.…”

“…This ICU admits approximately 1000 patients annually. The study was an extension of the BOSS‐ICU study, registered under the National Medical Research Register (NMR‐11‐1102‐9248), and was approved by the Medical Research and Ethics Committee. Inclusion criteria were: age above 18 years, and established systemic inflammatory response syndrome (SIRS) based on the American College of Chest Physician/Society of Critical Care Medicine (ACCP/SCCM) criteria .…”

Toddalolactone Protects Lipopolysaccharide-Induced Sepsis and Attenuates Lipopolysaccharide-Induced Inflammatory Response by Modulating HMGB1-NF-κB Translocation

“…Because of the nonspecificity of these two indicators, we did not use them to evaluate the efficacy of TA-8. Procalcitonin (PCT) and interleukin-6 (IL-6) have become popular biomarkers for predicting the prognosis of sepsis in the last decade (Ruiz-Rodriguez et al, 2012;Jekarl et al, 2013;Mat-Nor and Md Ralib, 2014;Mat-Nor et al, 2016). PCT is a specific marker of sepsis and is elevated in pro-inflammatory stimuli, especially bacterial-derived immune responses, and is also strongly associated with the severity of systemic inflammation (Elbirt et al, 2001;Enguix et al, 2001).…”