The Prognostic Role of Procalcitonin in Critically Ill Patients Admitted in a Medical Stepdown Unit: A Retrospective Cohort Study
| Autor: | Alessia Raponi, Lorenzo Falsetti, Mattia Sampaolesi, Aldo Salvi, Cinzia Nitti, Tamira Gentili, Annalisa Marchetti, Maria Novella Piersantelli, Vincenzo Zaccone, Francesca Riccomi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Organ Dysfunction Scores Disease-free survival Critical Illness lcsh:Medicine 030204 cardiovascular system & hematology Predictive markers Procalcitonin Article law.invention 03 medical and health sciences Prognostic markers 0302 clinical medicine law Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine Hospital Mortality Simplified Acute Physiology Score lcsh:Science Adverse effect Survival rate Aged Retrospective Studies Inflammation Multidisciplinary business.industry lcsh:R Retrospective cohort study Prognosis Intensive care unit Clinical trial Hospitalization Survival Rate Intensive Care Units lcsh:Q Female business Biomarkers |
| Zdroj: | Scientific Reports Scientific Reports, Vol 10, Iss 1, Pp 1-8 (2020) |
| ISSN: | 2045-2322 |
| Popis: | Procalcitonin (PCT) is a a marker of bacterial infection. Its prognostic role in the critically-ill patient, however, is still object of debate. Aim of this study was to evaluate the capacity of admission PCT (aPCT) in assessing the prognosis of the critically-ill patient regardless the presence of bacterial infection. A single-cohort, single-center retrospective study was performed evaluating critically-ill patients admitted to a stepdown care unit. Age, sex, Simplified Acute Physiology Score II (SAPS-II), shock, troponin-I, aPCT, serum creatinine, cultures and clinical endpoints (in-hospital mortality or Intensive Care Unit (ICU) transfer) were collected. Time free from adverse event (TF-AE) was defined as the time between hospitalization and occurrence of one of the clinical endpoints, and calculated with Kaplan-Meier curves. We engineered a new predictive model (POCS) adopting aPCT, age and shock.We enrolled 1063 subjects: 450 reached the composite outcome of death or ICU transfer. aPCT was significantly higher in this group, where it predicted TF-AE both in septic and non-septic patients. aPCT and POCS showed a good prognostic performance in the whole sample, both in septic and non-septic patients. aPCT showed a good prognostic accuracy, adding informations on the rapidity of clinical deterioration. POCS model reached a performance similar to SAPS-II. |
| Databáze: | OpenAIRE |
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