Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy

Objective: Role of serum procalcitonin (PCT) in critically ill patients is well defined for identification of bacterial infection but it’s role in prediction of survival is not well established. We studied plasma kinetics of PCT, over the first three critical care days to validate its role in predic...

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Main Authors: Abhishek Verma, Karan Kaushik, Amit Taluja, Pratik Shah
格式: 文件
语言:English
出版: Center for Scientific Research and Development of Education. 2024-01-01
丛编:Heart Vessels and Transplantation
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在线阅读:http://hvt-journal.com/articles/art454
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author Abhishek Verma
Karan Kaushik
Amit Taluja
Pratik Shah
author_facet Abhishek Verma
Karan Kaushik
Amit Taluja
Pratik Shah
author_sort Abhishek Verma
collection DOAJ
description Objective: Role of serum procalcitonin (PCT) in critically ill patients is well defined for identification of bacterial infection but it’s role in prediction of survival is not well established. We studied plasma kinetics of PCT, over the first three critical care days to validate its role in prediction of survival of patients with sepsis according to plasma level. Methods: A prospective observational study was conducted in CCU (KGMU). Total 53 consecutive patients either sex were recruited. Patients with systemic inflammatory response syndrome (SIRS) were recruited. PCT was measured on 1st and 3rd days. We studied 50 days survival using Kaplan-Meier analysis and diagnostic accuracy of PCT using ROC analysis. Results: In our study, PCT was statistically significantly higher in non-survivor patients compared to survivor patients (p<0.05). ROC curve was made with PCT based on culture at both time intervals. On the basis of ROC curve, we determined a cut-off value as 12.21 ng/ml of PCT on day 3 to predict sepsis with high sensitivity (93.7%) and specificity (71.4%). Area under curve (AUC) was also higher observed at day 3 (AUC=0.864, p<0.001) compared to day 1 (AUC=0.658, p<0.05). According to Kaplan-Meier curve, risk of mortality was by 83% (HR 0.17(95% 0.07-0.44)) lower in low sepsis category group (≤12.21 ng/ml) compared to high sepsis category group (>12.21 ng/ml). Conclusion: According to our study results, we conclude that serum PCT has good clinical diagnostic and prognostic values in prediction of survival in patients with sepsis. Kinetic studies of PCT can improve sensitivity and accuracy when evaluating the prognosis of patients with sepsis as well as survival rate.
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spelling doaj.art-0b59ca47bd714f89bbe3c6dc13b51a052024-01-30T07:55:29ZengCenter for Scientific Research and Development of Education.Heart Vessels and Transplantation1694-78861694-78942024-01-018110.24969/hvt.2024.454Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracyAbhishek Verma0Karan Kaushik1Amit Taluja2Pratik Shah3Department of Cardiac Anesthesia, U.N.Mehta Institute of Cardiology and Research Center Ahmadabad, Gujarat, IndiaDepartment of Cardiac Anesthesia, U.N.Mehta Institute of Cardiology and Research Center Ahmadabad, Gujarat, IndiaDepartment of Cardiac Anesthesia, U.N.Mehta Institute of Cardiology and Research Center Ahmadabad, Gujarat, IndiaU.N.Mehta Institute of Cardiology and Research Center Ahmadabad, Gujarat, IndiaObjective: Role of serum procalcitonin (PCT) in critically ill patients is well defined for identification of bacterial infection but it’s role in prediction of survival is not well established. We studied plasma kinetics of PCT, over the first three critical care days to validate its role in prediction of survival of patients with sepsis according to plasma level. Methods: A prospective observational study was conducted in CCU (KGMU). Total 53 consecutive patients either sex were recruited. Patients with systemic inflammatory response syndrome (SIRS) were recruited. PCT was measured on 1st and 3rd days. We studied 50 days survival using Kaplan-Meier analysis and diagnostic accuracy of PCT using ROC analysis. Results: In our study, PCT was statistically significantly higher in non-survivor patients compared to survivor patients (p<0.05). ROC curve was made with PCT based on culture at both time intervals. On the basis of ROC curve, we determined a cut-off value as 12.21 ng/ml of PCT on day 3 to predict sepsis with high sensitivity (93.7%) and specificity (71.4%). Area under curve (AUC) was also higher observed at day 3 (AUC=0.864, p<0.001) compared to day 1 (AUC=0.658, p<0.05). According to Kaplan-Meier curve, risk of mortality was by 83% (HR 0.17(95% 0.07-0.44)) lower in low sepsis category group (≤12.21 ng/ml) compared to high sepsis category group (>12.21 ng/ml). Conclusion: According to our study results, we conclude that serum PCT has good clinical diagnostic and prognostic values in prediction of survival in patients with sepsis. Kinetic studies of PCT can improve sensitivity and accuracy when evaluating the prognosis of patients with sepsis as well as survival rate.http://hvt-journal.com/articles/art454sepsissystemic inflammatory response syndromeprocalcitoninsurvivaloutcomediagnostic accuracy
spellingShingle Abhishek Verma
Karan Kaushik
Amit Taluja
Pratik Shah
Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
Heart Vessels and Transplantation
sepsis
systemic inflammatory response syndrome
procalcitonin
survival
outcome
diagnostic accuracy
title Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
title_full Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
title_fullStr Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
title_full_unstemmed Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
title_short Procalcitonin as a predictor of survival in patients with sepsis: A study on diagnostic accuracy
title_sort procalcitonin as a predictor of survival in patients with sepsis a study on diagnostic accuracy
topic sepsis
systemic inflammatory response syndrome
procalcitonin
survival
outcome
diagnostic accuracy
url http://hvt-journal.com/articles/art454
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AT karankaushik procalcitoninasapredictorofsurvivalinpatientswithsepsisastudyondiagnosticaccuracy
AT amittaluja procalcitoninasapredictorofsurvivalinpatientswithsepsisastudyondiagnosticaccuracy
AT pratikshah procalcitoninasapredictorofsurvivalinpatientswithsepsisastudyondiagnosticaccuracy