2019, Number 3
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Cir Cir 2019; 87 (3)
Evaluation of the serum procalcitonin level as an indicator of severity and mortality in abdominal sepsis due to secondary peritonitis
Godínez-Vidal AR, Rojas-Hernández V, Montero-García PJ, Martínez-Martínez AR, Zavala-Castillo JC, Gracida-Mancilla NI
Language: Spanish
References: 17
Page: 255-259
PDF size: 272.48 Kb.
ABSTRACT
Background: Procalcitonin is a biomarker of sepsis, whose concentrations increase when some endotoxin enters the bloodstream.
It is used, among other things, to discriminate the etiology of infections, increase or decrease the antibiotic spectrum,
and predict mortality.
Objective: To determine the utility of the serum level of procalcitonin as a predictor of severity and mortality.
Method: Retrospective, descriptive, cross-sectional study of patients diagnosed with abdominal sepsis during the period
from April 2016 to February 2017. In all cases the severity was determined by APACHE II, SOFA, Mannheim and CONUT, and
mortality. The sample was divided into those with procalcitonin › 10.1 and ‹ 10.
Results: We included 99 cases (41 female
and 58 male). The main organ causing abdominal sepsis was the appendix 56%. The mean of procalcitonin for the sample was
7.94 (standard deviation: ± 13.76). The findings, subjected to statistical verification by means of the Mann-Whitney U test, showed
statistical significance among the cases with procalcitonin 10.1, with the Mannheim scores › 26 points (p = 0.003), CONUT › 6 points (p = 0.027) and presence of organic faults (p = 0.001), but not with APACHE, SOFA and mortality.
Conclusions: Procalcitonin
is related to the severity determined by the Mannheim index, CONUT and the development of organic faults.
REFERENCES
Christ-Crains M, Müller B. Procalcitonin on the dusty way to the holy grail: a progress report. En: Vicent JL, editor. Yearbook of intensive care and emergency medicine. Berlín: Springer-Verlag; 2005. p. 461-76.
Dandona P, Nix D, Wilson MF, Aljada A, Love J, Assicot M, et al. Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab. 1994;79:1605-8.
Morgenthaler NG, Struck J, Fischer-Schulz C, Bergmann A. Sensitive immunoluminometric assay for the detection of pro-calcitonin (Department BRAHMS AG, Biotechnology Centre). Clin Chem. 2002;28:788-9.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 2003;29:530-8.
León Gil C, García-Castrillo Riesgo L, Moya Mir M, Artigas Raventós A, Borges SM, Candewl González FJ, et al. Recomendaciones del manejo diagnóstico-terapeútico inicial y multidisciplinario de la sepsis grave en los servicios de urgencias hospitalarios. Documento de consenso (SEMES- SEMICYUC). Med Intensiva. 2007;31:375-87.
Guidet B, Aegerter P, Gauzit R, Meshaka P, Dreyfuss D, CUB- Réa Study Group. Incidence and impact of organ dysfunctions associated with sepsis. Chest. 2005;127:942-51.
Castellanos-Ortega A, Suberviola B, García-Astudillo LA, Holanda MS, Ortiz F, Llorca J, et al. Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: results of a threeyear follow-up quasi experimental syudy. Crit Care Med. 2010;38:1036-43.
Marshall JC, Vincent JL, Fink MP, Cook DJ, Rubenfeld G, Foster D, et al. Measures, markers and mediators: toward a staging system for clinical sepsis. A report of the fifth Toronto sepsis roundtable. Toronto, Ontario, Canada. Crit Care Med. 2003;31:1560-7.
Marshall JC, Reinhart K. For the International Sepsis Forum. Biomarkers of sepsis. Crit Care Med. 2009;37:2290-8.
Ventetuolo CE, Levy MM. Biomarkers: diagnosis and risk assessment in sepsis. Clin Chest Med. 2008;29:591-603.
Gerlach H, Toussaint S. Sensitive, specific, predictive. statistical basics: how to use biomarkers. Crit Care Clin. 2011;27:215-27.
Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta- analysis. Lancet Infect Dis. 2007;7:210-7.
Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Crit Care. 2010;14(1) R15.
Liaudat S, Dayer E, Praz G, Bille J, Troillet N. Usefulness of procalcitonin serum level for the diagnosis of bacteremia. Eur J Clin Microbiol Infect Dis. 2001;20:524-7.
Zakariah AN, Cozzi SM, Van Nuffelen M, Clausi CM, Pradier O, Vincent JL. Combination of biphasic transmittance waveform with blood procalcitonin levels for diagnosis of sepsis in acutely ill patients. Crit Care Med. 2008;36:1507-12.
Deitcher SR, Eisenberg PR. Elevated concentrations of cross-linked fibrin degradation products in plasma. An early marker of gram-negative bacteremia. Chest. 1993;103:1107-12.
Schuetz P, Hausfater P, Amin D, Amin A, Haubitz S, Faessler L, et al. Biomarkers from distinct biological pathways improve early risk stratification in medical emergency patients: the multinational, prospective, observational TRIAGE study. Crit Care. 2015;19:377.