Prognostic value of procalcitonin in children with meningococcal sepsis.
OBJECTIVE
To compare procalcitonin, lactate, and C-reactive protein as prognostic markers in children with meningococcal septic shock.


METHODS
Prospective observational study.


METHODS
Alder Hey Children's Hospital, Liverpool, UK.


METHODS
Children admitted to our hospital during a 16-month period with a diagnosis of meningococcal sepsis.


RESULTS
Plasma procalcitonin at admission was significantly higher in children with septic shock (median, 73.80 vs. 16.44 ng/mL), those requiring ventilation (median, 47.02 vs. 12.00 ng/mL), and those with a duration of hospital stay >10 days (median, 131.35 vs. 19.26 ng/mL). Both procalcitonin and lactate reliably discriminated between those children with septic shock (area under the curve [AUC] = 0.85 and 0.84, respectively) and durations of hospital stay exceeding 10 days (AUC = 0.87 and 0.79, respectively) and those without, but C-reactive protein did not. Procalcitonin alone reliably discriminated between those children requiring ventilation and those who did not (AUC = 0.72).


CONCLUSIONS
Procalcitonin is a reliable prognostic marker of septic shock, requirement for ventilation, and prolonged hospital stay in children with meningococcal sepsis and performs better than lactate and C-reactive protein.
Carrol
Enitan D
ED
Institute of Child Health, Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK.
Newland
Paul
P
Thomson
Alistair P J
AP
Hart
C Anthony
CA
D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D003422:Critical Care; D017052:Hospital Mortality; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D008589:Meningococcal Infections / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012121:Respiration, Artificial; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality; D015996:Survival Rate
C000606589:CALCA protein, human; D011498:Protein Precursors; D019344:Lactic Acid; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide