Predictive value of Procalcitonin Clearance for Prognosis in Intensive Care Unit Patients with Sepsis: A Cohort Study
Author(s): Xuan Song, Gangbing Song, Xinyan Liu, Huairong Wang, Xiuyan Guo, Maopeng Yang, Daqiang Yang, Yahu Bai, Ziwei Liu, Nana Zhang
Objective: Early diagnosis, accurate assessment of the prognosis are essential for the effective treatment of sepsis patients. To investigate the predictive value of procalcitonin clearance (PCTc) for prognostic evaluation of the patients with sepsis.
Material and Methods: Clinical data of 138 patients with sepsis and septic shockwere retrospectively collected. Procalcitonin (PCT) was collected for 4 consecutive days after sepsis diagnosis and PCTc was calculated.
Results: The overall 28-day mortality rate was 23.2% (32/138). The PCTc in the survival group was significantly higher than that in the death group after 48 hours [57.51 (36.06 to 70.73)% vs. 6.6 (-35.33 to 43.93)%, P < 0.001], as well as after 72 hours of treatment [77.47 (59.84 to 86.31)% vs. 22.30 (-62.38 to 63.44)%, P < 0.001]. ROC curve analysis indicated that the area under the curve of 48-hour PCTc (PCTc-48) was 0.811, 95% CI (0.724, 0.898), P < 0.001, while 72-hour PCTc (PCTc-72) was 0.818, 95% CI (0.734, 0.902), P < 0.001. In addition, we found that the difference between the prognosis of sepsis caused by different infection sites was statistically significant (P < 0.001), Sepsis patients with pulmonary infection showed the worst prognosis compared with urinary tract infection and abdominal infection.
Conclusion: PCTc can be an important indicator to evaluate the prognosis in patients with sepsis. PCTc and infection site are risk factors for the prognosis in patients with sepsis.