Use of procalcitonin for early prediction of lethal outcome of postoperative sepsis.
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.
Novotny
Alexander
A
Department of Surgery, Klinikum rechts der Isar, Technische Universität, Ismaninger Str. 22, 81675 Munich, Germany. novotny@chir.med.tu-muenchen.de
Emmanuel
Klaus
K
Matevossian
Edouard
E
Kriner
Monika
M
Ulm
Kurt
K
Bartels
Holger
H
Holzmann
Bernhard
B
Weighardt
Heike
H
Siewert
Jörg-Rüdiger
JR
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*
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide