Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study.
Crit Care. 2010 Nov 15;14(6):R205
Authors: Karlsson S, Heikkinen M, Pettila V, Alila S, Vaisanen S, Pulkki K, Kolho E, Ruokonen E
ABSTRACT: INTRODUCTION: This prospective study investigated the predictive value of procalcitonin (PCT) for survival in 242 adult patients with severe sepsis and septic shock treated in intensive care. METHODS: PCT was analyzed from blood samples of all patients at baseline, and 155 patients 72 hours later. RESULTS: The median PCT serum concentration on day 0 was 5.0 ng/ml (Interquartile range (IQR) 1.0 and 20.1 ng/ml) and 1.3 ng/ml (IQR 0.5 and 5.8 ng/ml) 72 hours later. Hospital mortality was 25.6% (62/242). Median PCT concentrations in patients with community-acquired infections were higher than with nosocomial infections (P=0.001). Blood cultures were positive in 28.5% of patients (n=69), and severe sepsis with positive blood cultures was associated with higher PCT levels than with negative cultures (P = <0.001). Patients with septic shock had higher PCT concentrations than patients without (P=0.02). PCT concentrations did not differ between hospital survivors and nonsurvivors (P=0.64 and P=0.99, respectively), but mortality was lower in patients whose PCT concentration decreased >50% (by 72 hours) compared to those with a <50% decrease (12.2% vs. 29.8%, P=0.007). CONCLUSIONS: PCT concentrations were higher in more severe forms of severe sepsis, but a substantial concentration decrease was more important for survival than absolute values.
PMID: 21078153 [PubMed - as supplied by publisher]