title: Use of procalcitonin for early prediction of lethal outcome of postoperative sepsis.
abstract: BACKGROUND
  To develop strategies for the prediction of sepsis outcome systemic procalcitonin (PCT) levels were correlated with various clinical parameters.
  
  
  METHODS
  PCT levels and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were assessed on the day of sepsis diagnosis in a large series (n = 160) of patients developing sepsis after major visceral surgery.
  
  
  RESULTS
  In multivariate analysis, systemic PCT and the APACHE II score could be identified as independent early predictive indicators of lethal sepsis. Combining both indicators at sepsis onset, a prognosis score could be calculated using binary logistic regression analysis allowing the identification of high- and low-risk groups. While 71% of the high-risk patients died of sepsis, 77% of patients assigned to the low-risk group survived the septic complication (sensitivity 71%, specificity 77%).
  
  
  CONCLUSIONS
  Calculation of the prognosis-score allowed for an early prediction of the septic course with high sensitivity and specificity. This information could aid in deciding on adequate treatment strategies.
authors.affiliation: Department of Surgery, Klinikum rechts der Isar, Technische Universität, Ismaninger Str. 22, 81675 Munich, Germany. novotny@chir.med.tu-muenchen.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Novotny
authors.forename: Klaus
authors.initials: K
authors.lastname: Emmanuel
authors.forename: Edouard
authors.initials: E
authors.lastname: Matevossian
authors.forename: Monika
authors.initials: M
authors.lastname: Kriner
authors.forename: Kurt
authors.initials: K
authors.lastname: Ulm
authors.forename: Holger
authors.initials: H
authors.lastname: Bartels
authors.forename: Bernhard
authors.initials: B
authors.lastname: Holzmann
authors.forename: Heike
authors.initials: H
authors.lastname: Weighardt
authors.forename: Jörg-Rüdiger
authors.initials: JR
authors.lastname: Siewert
mesh_terms: D018806:APACHE; D000368:Aged; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood / Q000209:etiology* / Q000401:mortality*
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide