Procalcitonin as a diagnostic and prognostic marker in chronically-critically ill patients
Abstract number: P1080
Tsangaris H., Kavatha D., Gourgoulis M., Plachouras D., Paramythiotou E., Karampekiou E., Armaganidis A., Giamarellou H.
Objective: To investigate Procalcitonin (PCT) levels as prognostic markers of infection and to correlate maximum as well as every other day changes of PCT levels to mortality of chronically critically ill patients.
Methods: This is study including all patients hospitalised for more than 10 days in ICU. Blood samples for PCT, WBC, and CRP were drawn every other day. Patients were classified to one of the following groups according to ACCPM 1994 criteria 0: no infection, 1: localised infection and sepsis, 2: severe sepsis and septic shock and SOFA score was recorded. PCT concentrations were measured by an automated immunofluorescent assay (PCT KRYPTOR) PCT values were categorised as alert and non alert values using x-bar test. Maximum PCT (PCT max) levels and number of days with PCT higher than the alert value were compared between survivors and non-survivors. All PCT levels were correlated with CRP, WBC and SOFA score with the Spearman test and compared among the various groups of severity of infection by one-way ANOVA. Categorical variables were compared using the chi-square test and continuous variables with non-parametric MannWhitney U test.
Results: PCT plasma concentrations were measured in a total of 169 samples collected from 11 patients (8 male and 3 female) followed up for a mean of 34.5 days (range 14 to 67) until discharge or death. The alert value in this population was calculated as 0.88 ng/ml. Mean PCT (±SD) concentration of patients categorised as having no infection, sepsis and severe sepsisseptic shock were 0.47 (±0.40), 1.86 (±3.86) and 4.82 (±7.58) respectively (p < 0.0001). There was a definite but weak correlation between PCT concentrations, CRP (Spearman's rho 0.21, p < 0.007) and SOFA score (Spearman's rho 0.3, p < 0.0001) but not with WBC. PCT max was 4.33 in survivors and 12.98 in non-survivors (p NS). Mean total days with PCT higher than alert value were 2.44 and 5.66 respectively (p NS)
Conclusions: Mean PCT plasma concentrations correlated to the severity of the infection. There was a weak correlation among PCT, CRP and SOFA score and a trend to higher mean PCT values and to more mean total days above the alert value in non-survivors than survivors.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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