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Critical Care Research and Practice
Volume 2014, Article ID 819034, 7 pages
http://dx.doi.org/10.1155/2014/819034
Clinical Study

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

Department of Anaesthesiology and Intensive Care, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Hospital Campus, 25000 Kuantan, Pahang, Malaysia

Received 7 November 2013; Revised 13 January 2014; Accepted 13 January 2014; Published 24 February 2014

Academic Editor: Timothy E. Albertson

Copyright © 2014 Mohd Basri Mat Nor and Azrina Md Ralib. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.