Usefulness of procalcitonin as a predictor for bacteremia and prognosis in severe sepsis

Abstract

Introduction: Severe sepsis and septic shock, responsible for the high mortality rate in the intensive care unit. Identifying a reliable biomarker able to quickly and acurrately diagnose sepsis is very important in critical care.

Aims and objectives: This study aimed to evaluate the usefulness of procalcitonin as a predictor for bacteremia and prognosis in severe sepsis.

Methods: We analyzed the medical records of 148 patients who presented with severe sepsis defined by the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus Conference definitions, at Gangnam Severance Hospital, a tertiary referral medical center in Seoul, Korea.

Results: Of 148 patients, 77 patients (52.0%) had bacteremia. The median age was 67.5 years and 94 patients (63.5%) were male. Baseline characteristics and other inflammatory markers including C-reactive protein and delta neutrophil counts showed no significant difference between bacteremia and non-bacteremia groups. Procalcitonin showed no significant difference according to the type of infection. Bacteremia group showed significantly higher procalcitonin level (1.68, range 0.07-100.00) than non-bacteremia group (0.32, range 0.00-107.16) (p=0.032). With a cut-off value of 0.5 ng/ml, procalcitonin was the meaningful predictor for death (OR 2.878 (1.367-6.058), p=0.005), as well as for bacteremia (OR 2.879 (1.459-5.681), p=0.002).

Conclusion: Procalcitonin is a useful marker to predict bacteremia and prognosis in severe sepsis.