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2015 ; 10
(9
): e0138150
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Clinical Usefulness of Procalcitonin and C-Reactive Protein as Outcome Predictors
in Critically Ill Patients with Severe Sepsis and Septic Shock
#MMPMID26367532
Ryu JA
; Yang JH
; Lee D
; Park CM
; Suh GY
; Jeon K
; Cho J
; Baek SY
; Carriere KC
; Chung CR
PLoS One
2015[]; 10
(9
): e0138150
PMID26367532
show ga
Sepsis is a major cause of mortality and morbidity in critically ill patients.
Procalcitonin (PCT) and C-reactive protein (CRP) are the most frequently used
biomarkers in sepsis. We investigated changes in PCT and CRP concentrations in
critically ill patients with sepsis to determine which biochemical marker better
predicts outcome. We retrospectively analyzed 171 episodes in 157 patients with
severe sepsis and septic shock who were admitted to the Samsung Medical Center
intensive care unit from March 2013 to February 2014. The primary endpoint was
patient outcome within 7 days from ICU admission (treatment failure). The
secondary endpoint was 28-day mortality. Severe sepsis was observed in 42 (25%)
episodes from 41 patients, and septic shock was observed in 129 (75%) episodes
from 120 patients. Fifty-five (32%) episodes from 42 patients had
clinically-documented infection, and 116 (68%) episodes from 99 patients had
microbiologically-documented infection. Initial peak PCT and CRP levels were not
associated with treatment failure and 28-day mortality. However, PCT clearance
(PCTc) and CRP (CRPc) clearance were significantly associated with treatment
failure (p = 0.027 and p = 0.030, respectively) and marginally significant with
28-day mortality (p = 0.064 and p = 0.062, respectively). The AUC for prediction
of treatment success was 0.71 (95% CI, 0.61-0.82) for PCTc and 0.71 (95% CI,
0.61-0.81) for CRPc. The AUC for survival prediction was 0.77 (95% CI, 0.66-0.88)
for PCTc and 0.77 (95% CI, 0.67-0.88) for CRPc. Changes in PCT and CRP
concentrations were associated with outcomes of critically ill septic patients.
CRP may not be inferior to PCT in predicting outcome in these patients.