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2024, Number 1

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Med Crit 2024; 38 (1)

Procalcitonin versus dimer D as predictors of mortality in sepsis

Guzmán HA

Language: Spanish
References: 28
Page: 27-34
PDF size: 227.33 Kb.


ABSTRACT

Introduction: it is considered that up to 50% of ICU beds are occupied by patients with sepsis. Sepsis is the most common cause of in-hospital deaths, costing more than $ 24 billion annually globally. Objective: demonstrate that D-dimer is better than procalcitonin in predicting mortality in patients with sepsis. Material and methods: observational, descriptive, longitudinal, ambispective, comparative and analytical study. Study population: patients who were admitted with sepsis criteria to the Adult Intensive Care Unit of the La Villa General Hospital of the SSCDMX. Study period is from April 2022 to June 2023. Results: 250 records were reviewed, of which 66 patients were selected. The mean age was 50 years with one (± 15.3), the male gender was (54.5%, n = 36). The median number of days of stay hospitalization was four (range: 2-7.25). The median of initial procalcitonin was 7.4 ng/mL (range: 3.3-43.3); the median of procalcitonin at 24 hours, 11.3 ng/mL (range: 5.8-51.8); the median of dimer initial D, 2,400 µm/mL (range: 1,487-3,772); median D-dimer at 24 hours, 3,175 µm/mL (range: 1,665-4,554). Among the comorbidities, Among the comorbidities were recorded: diabetes mellitus (33.3%, n = 22), systemic arterial hypertension (27.3%, n = 18), liver disease (6.1%, n = 4), chronic kidney disease (4.5%, n = 3), pregnancy (4.5%, n = 3), neoplasms (1.5%, n = 1), heart disease (1.5%, n = 1), mortality in this study was 37.9%. A multivariate risk analysis was performed, with a Kaplan-Meier survival graph, and initial procalcitonin OR 1.71 (95% CI 1.43-3.19, p = 0.045), procalcitonin at 24 hours, an OR 0.53 (95% CI 0.620-2.37, p = 0.063); the initial D-dimer greater than 500 obtained an OR 1.40 (95% CI 1.27-2.72, p = 0.030), the D-dimer greater than 500 after 24 hours obtained an OR 2.0 (95% CI 1.62-2.36, p = 0.004). Conclusions: procalcitonin has a greater impact on mortality than D-dimer. D-dimer has the same impact as procalcitonin on 24 hours mortality.


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