Prognostic Value of Serum Procalcitonin in Patients with Sepsis in a Tertiary Level Hospital

Aflatun Akter Jahan, Md. Raziur Rahman, J. Ahmed, Sameena Khan
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Abstract

Background: Sepsis is a complex, life-threatening, heterogeneous infectious disease associated with increased rates of morbidity and mortality. Early assessment of the prognosis of sepsis is key to achieving a favorable outcome for the disease. This study aimed to identify the prognostic value of PCT for sepsis patients. Materials and Methods: We conducted a prospective analytical study involving 100 adult patients with sepsis who were admitted to the Medicine dept and intensive care unit from 2019 to 2020. At least one blood test for PCT level was performed for all patients within the first 24 hours of suspecting an infection. Results: Our study found that a maximum number of patients (43.0%) were between 51-60 years age group, mean age of the patient was 49.35 ± 11.7 years. Out of 100 cases, 65% were male and 35% were female. The male and female ratio was 1.85:1. In this study serum, procalcitonin levels 0.5-2.0 ng/were detected in 15.0% of patients with mean±SD 1.3±0.8. Serum procalcitonin levels 2.1-10.0 ng/mL were detected in 29.0% of patients with mean±SD 5.9±2.5 and >10.0 ng/mL was detected in 56 patients. Based on the receiver-operator characteristic (ROC) curves, procalcitonin had the area under curve 0.923, with 89.4% sensitivity and 87.5% specificity. In our study, procalcitonin showed the best predictive value for the short-term outcome of sepsis with a cut-off value of 14.8 ng/mL (AUC 0.923). Study shows that 76.0% of the patients recovered completely, but 24.0% of patients expired during the hospital stay. Conclusion: There was a statistically significant correlation in serum procalcitonin with the outcome of sepsis (p < 0.001). So the effectiveness of serum procalcitonin has proven significant in the prediction of mortality in sepsis patients. J MEDICINE 2023; 24: 18-22
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某三级医院脓毒症患者血清降钙素原的预后价值
背景:脓毒症是一种复杂的、危及生命的、异质性的传染病,发病率和死亡率增加。败血症预后的早期评估是获得良好预后的关键。本研究旨在确定PCT对败血症患者的预后价值。材料和方法:我们进行了一项前瞻性分析研究,涉及2019年至2020年入住医学部和重症监护室的100名败血症成年患者。在怀疑感染的最初24小时内,对所有患者进行了至少一次PCT水平的血液测试。结果:我们的研究发现,51-60岁年龄组的患者最多(43.0%),患者的平均年龄为49.35±11.7岁。在100例病例中,65%为男性,35%为女性。男女比例为1.85:1。在这项研究的血清中,15.0%的患者的降钙素原水平为0.5-2.0 ng/,平均值±SD 1.3±0.8。29.0%的患者检测到血清降钙素原水平为2.1-10.0 ng/mL,平均值±SD 5.9±2.5,56名患者检测到>1.0 ng/mL。根据受试者-操作者特征(ROC)曲线,降钙素原的曲线下面积为0.923,敏感性为89.4%,特异性为87.5%。在我们的研究中,降钙素原对败血症的短期结果显示出最佳的预测价值,其临界值为14.8ng/mL(AUC 0.923)。研究表明,76.0%的患者完全康复,但24.0%的患者在住院期间过期。结论:血清降钙素原与脓毒症的预后有统计学意义(p<0.001),因此血清降钙激素原对脓毒症患者死亡率的预测具有重要意义。J医学2023;24:18-22
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