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2011, Number 1

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Acta Med 2011; 9 (1)

Procalcitonin as a factor for mortality prediction in intensive therapy

Plascencia ZLA, Pizaña DA, Morales CI

Language: Spanish
References: 27
Page: 5-11
PDF size: 217.53 Kb.


ABSTRACT

Introduction: Severe sepsis is the main cause of mortality in the Intensive Care Unit (ICU). In a recent study it was found that the PCT increase in a day is an independent predictor of mortality, and the day to day changes in its level may identify patients with a high mortality risk in the ICU. Material and methods: All patients older than 18 years of age from August 2007 to January 2008 were included in a prospective, observational and longitudinal cohort study. Results: 95 patients were analyzed with an average ICU stay of 6 days and hospital stay of 12 days. The most frequent diagnosis was septic shock and severe sepsis. Mortality was 30%. The highest PCT value and the value on the day of death correlated with the prognostic mortality scales, but not with length of stay in the ICU or length of stay in the hospital. Discussion: Bacterial endotoxins are the greatest stimulus for the induction of PCT, but infections by Gram-positive organisms can also release PCT. When correlating the PCT with the values at death in the severity scales only had a significant link with APACHE II (p ‹ 0.009). Though this correlationship is moderate according to Spearman’s correlationship analysis, it is probably due to a small sample size since a greater sample size may increase this correlation. Conclusions: The study was unable to prove PCT as an independent factor of mortality, but a significant link to the most widely used severity scale, APACHE II, was found. PCT measured daily did prove to have diagnostic value, and the changes in levels of it may identify patients with a high risk of death.


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