Critical Care |

Usefulness of Procalcitonin as a Prognostic Marker in Patients Admitted to the Medical Intensive Care Unit FREE TO VIEW

Xubin Huang, MPH; Jun Zhang, MD; Xinyan Huang, MD; Wanmei He, MD; Mian Zeng, MD
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the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

Chest. 2015;148(4_MeetingAbstracts):242A. doi:10.1378/chest.2228379
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SESSION TITLE: Critical Care Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The usefulness of procalcitonin (PCT) acting as a prognostic marker in unselected and non-surgical critically ill patients is unclear. The present study prospectively detected whether PCT measured at medical intensive care unit (ICU) admission is predictive of 28-day mortality in an unselected cohort of non-surgical critically ill patients in a single center.

METHODS: A total of 213 consecutive patients admitted to the Medical Intensive Care Unit (medical ICU), in a tertiary university hospital, during a 12-month period between January 2014 and December 2014, were assessed. Patients with recent major surgery in a month were excluded.

RESULTS: The median age was 61 yr (range, 15-93 yr; IQR, 45-73), and 63.9% of the patients were male. The median level of PCT on ICU admission was 1.51ng/mL (range, 0.05-189.72ng/mL; IQR, 0.35-7.05ng/mL), and the median APACHE II score was 21 (range, 8-43). The 28-day mortality rate was 46.0%. The 28-day survivors did not show significantly different levels of PCT from non-survivors (1.07 ng/mL [range, 0.05-189.72 ng/mL] vs. 2.27ng/mL [range, 0.05-159.00 ng/mL], P>0.05). In prediction of 28-day mortality, the area under the curve (AUC) for PCT was 0.61 (95% confidence interval [CI], 0.53-0.69) and APACHE II score was 0.68 (95% CI, 0.61-0.75). AUC was increased little when PCT was combined with APACHE II.

CONCLUSIONS: There was no significant difference in the level of PCT between survivors and non-survivors in a cohort of non-surgical critically ill patients in a medical ICU. Moreover, combining PCT with APACHE II score added little additional power in predicting 28-day mortality in this unselected cohort of patients in a single center.

CLINICAL IMPLICATIONS: PCT at ICU admission in non-selected medical ICU patients did not provide sufficient information for prediction of 28-day mortality. The role of PCT in predicting prognosis of non-selected medical ICU patients might be limited. Further investigation of PCT in critically ill patients with specific clinical feature is needed.

DISCLOSURE: The following authors have nothing to disclose: Xubin Huang, Jun Zhang, Xinyan Huang, Wanmei He, Mian Zeng

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