Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi

ABSTRACT Introduction: To investigate the role of initial procalcitonin (PCT) level as an early predictor of septic shock for the patient with sepsis induced by acute pyelonephritis (APN) secondary to ureteral calculi. Materials and Methods: The data from 49 consecutive patients who met criteria o...

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Main Authors: Young Hwii Ko, Yoon Seob Ji, Sin-Youl Park, Su Jin Kim, Phil Hyun Song
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia 2016-04-01
Series:International Brazilian Journal of Urology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200270&lng=en&tlng=en
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author Young Hwii Ko
Yoon Seob Ji
Sin-Youl Park
Su Jin Kim
Phil Hyun Song
author_facet Young Hwii Ko
Yoon Seob Ji
Sin-Youl Park
Su Jin Kim
Phil Hyun Song
author_sort Young Hwii Ko
collection DOAJ
description ABSTRACT Introduction: To investigate the role of initial procalcitonin (PCT) level as an early predictor of septic shock for the patient with sepsis induced by acute pyelonephritis (APN) secondary to ureteral calculi. Materials and Methods: The data from 49 consecutive patients who met criteria of sepsis due to APN following ureteral stone were collected and divided into two groups: with (n=15) or without (n=34) septic shock. The clinical variables including PCT level for this outcome were retrospectively compared by univariate analysis, followed by multivariable logistic regression model. Results: All subjects had hydronephrosis, and were hospitalized with the mean of 11.8 days (3–42 days). The mean size of the ureteral stones was 7.5mm (3–30mm), and 57% were located in upper ureter. At univariate analysis, patients with septic shock were significantly older, a higher proportion had hypertension, lower platelet count and serum albumin level, higher CRP and PCT level, and higher positive blood culture rate. Multivariate models indicated that lower platelet count and higher PCT level are independent risk factors (p=0.043 and 0.046, respectively). In ROC curve, the AUC was significantly wider in PCT (0.929), compared with the platelet count (0.822, p=0.004). At the cut-off of 0.52ng/mL, the sensitivity and specificity were 86.7% and 85.3%. Conclusion: Our study demonstrated elevated initial PCT levels as an early independent predictor to progress into septic shock in patients with sepsis associated with ureteral calculi.
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spelling doaj.art-c3925738658b40cc9604ccdb9f45819c2022-12-21T23:22:44ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192016-04-0142227027610.1590/S1677-5538.IBJU.2014.0465S1677-55382016000200270Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculiYoung Hwii KoYoon Seob JiSin-Youl ParkSu Jin KimPhil Hyun SongABSTRACT Introduction: To investigate the role of initial procalcitonin (PCT) level as an early predictor of septic shock for the patient with sepsis induced by acute pyelonephritis (APN) secondary to ureteral calculi. Materials and Methods: The data from 49 consecutive patients who met criteria of sepsis due to APN following ureteral stone were collected and divided into two groups: with (n=15) or without (n=34) septic shock. The clinical variables including PCT level for this outcome were retrospectively compared by univariate analysis, followed by multivariable logistic regression model. Results: All subjects had hydronephrosis, and were hospitalized with the mean of 11.8 days (3–42 days). The mean size of the ureteral stones was 7.5mm (3–30mm), and 57% were located in upper ureter. At univariate analysis, patients with septic shock were significantly older, a higher proportion had hypertension, lower platelet count and serum albumin level, higher CRP and PCT level, and higher positive blood culture rate. Multivariate models indicated that lower platelet count and higher PCT level are independent risk factors (p=0.043 and 0.046, respectively). In ROC curve, the AUC was significantly wider in PCT (0.929), compared with the platelet count (0.822, p=0.004). At the cut-off of 0.52ng/mL, the sensitivity and specificity were 86.7% and 85.3%. Conclusion: Our study demonstrated elevated initial PCT levels as an early independent predictor to progress into septic shock in patients with sepsis associated with ureteral calculi.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200270&lng=en&tlng=enUreteral CalculiPyelonephritisShockSeptic
spellingShingle Young Hwii Ko
Yoon Seob Ji
Sin-Youl Park
Su Jin Kim
Phil Hyun Song
Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
International Brazilian Journal of Urology
Ureteral Calculi
Pyelonephritis
Shock
Septic
title Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
title_full Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
title_fullStr Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
title_full_unstemmed Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
title_short Procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
title_sort procalcitonin determined at emergency department as an early indicator of progression to septic shock in patient with sepsis associated with ureteral calculi
topic Ureteral Calculi
Pyelonephritis
Shock
Septic
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000200270&lng=en&tlng=en
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