Admission procalcitonin in septic shock associated with mortality risk: Study
USA: Admission procalcitonin (Procal) level in septic shock may be a risk factor for increased mortality but further studies are needed before utilizing it as a tool for risk stratification or prognosticate patients being admitted to the ICU, says a recent study. The study findings were presented at the American Thoracic Society (ATS) 2022 International Conference, held in San Francisco, CA, from May 13 to 18.
Septic shock is the leading death cause in the ICU. Previous studies have shown that increased levels of Procal may be associated with increased mortality in sepsis. There is debate on the role of biomarkers such as procalcitonin in the outcome of sepsis, as studies have yielded variable results. K. Bhandari, University of Connecticut School of Medicine, Farmington, CT, United States, and colleagues, therefore, aimed to determine the relation of procalcitonin level at admission with clinical outcomes in patients with septic shock.
For this purpose, the researchers retrospectively reviewed the records of 256 patients admitted to the ICU with septic shock. The following data was recorded from records -- admission Procal levels, patient demographics, number of positive cultures, cause of septic shock, duration of MV and pressor requirement, number of patients on pressors and mechanical ventilation (MV), ICU length of stay (LOS), stress dose steroid requirement, and mortality at hospital discharge and at 30 days. The association between PCT and outcomes was assessed using Pearson's correlation analysis.
Based on the study, the researchers found the following:
- Of the 256 patients reviewed, the mean age was 71.4 + 15.8 years and 60% were male.
- Seventy-five percent required pressors; 51% required MV.
- Mean admission Procal was: 9.9 + 26.5 ng/ml; 49.9% required stress dose steroids. Sixty-nine percent had positive cultures (27% + blood, 22% + sputum, 15% + urine). Seventy-five percent required pressors; mean ICU LOS: 8.3 + 14 days; mean hospital LOS:14.5 + 16 days.
- Sixty percent of patients survived to discharge. 30-day mortality was: 42.4%. On correlation analysis, no significant association was noted between Procal and (i) positive cultures (r= 0.112); (ii) need for pressor ( r= 0.029); (iii) need for stress dose steroids ( r= 0.-0.063); (iv)need for MV (( r= - 0.091); (v) ICU LOS (r=-0.089); (VI) Hosp LOS (r= -0.08).
- Higher Procal was associated with increased mortality at discharge ( r= 0.131) and 30-day mortality (( r= 0.0.152).
The researchers conclude, "our findings suggest that Procal may represent a risk factor for increased mortality but requires further studies before being utilized as a tool to risk stratify or prognosticate patients being admitted to the ICU."
Reference:
https://www.abstractsonline.com/pp8/#!/10476/presentation/7494
