Abstract
Background: The changes of procalcitonin (PCT) acting as a prognostic factor in critically ill patients with sepsis is not fully interpreted. We prospectively studied whether the evolution of PCT is predictive of 28-day mortality in a cohort of critically ill patients with sepsis.
Methods: A total of 133 consecutive patients with sepsis admitted to the Medical Intensive Care Unit (ICU) in a tertiary hospital during a 12-month period between April 2014 and March 2015, were assessed.
Results: The median age was 61 yr (range, 18–89 yr; IQR, 49–73), and 58.6% of the patients were male. The median level of PCT on ICU admission (PCT on D0) was 4.81 ng/mL (IQR, 0.93–26.73 ng/mL), and the median APACHE II score was 23 (range, 9–46). The 28-day mortality rate was 55.6%. The 28-day survivors did not show significantly lower levels of PCT from non-survivors on ICU admission (3.31 ng/mL vs. 5.08 ng/mL, P>0.05). There were 85 patients with ICU stay more than 6 days, with the median level of PCT on D6 was 1.55 ng/mL (IQR, 0.53–6.66 ng/mL). In prediction of 28-day mortality, the area under the curve (AUC) for PCT on D0 was 0.55 (95% confidence interval [CI], 0.45–0.66) and APACHE II score was 0.70 (95% CI, 0.61–0.79). For those with ICU stay>6 days, AUC for PCT on D6 was 0.76 (95%CI, 0.66–0.86) and APACHE II score was 0.59 (95% CI, 0.46–0.71). AUC was 0.76 (95%CI, 0.66–0.86) when PCT was combined with APACHE II.
Conclusions: The 28-day survivors did not show significantly different levels of PCT from non-survivors on ICU admissiontients in this cohort of patients. Combining PCT on D6 rather than PCT on D0 with APACHE II score added additional power in predicting 28-day mortality in this cohort of patients.
- Copyright ©ERS 2015
