title: Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma.
abstract: OBJECTIVE
  The primary aim of this study was to investigate the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) in septic complications after major trauma. A secondary aim was to determine whether there was a prognostic value of PCT for severity of injury, organ dysfunction, and sepsis.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Medical/surgical intensive care unit (ICU).
  
  
  METHODS
  Ninety-four patients with consecutive trauma >or=16 years who were admitted to the ICU for an expected stay of >24 hours.
  
  
  METHODS
  None.
  
  
  METHODS
  PCT and CRP were collected at admission and every day thereafter. The American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definition was used to identify sepsis criteria. The Sequential Organ Failure Assessment score was used to describe the severity of organ dysfunction. We retrospectively analyzed the occurrence of systemic inflammatory response syndrome and sepsis using the collected variables (criteria fulfilled at least during three continuous days).
  
  
  RESULTS
  Patients with trauma presented an early and significant increase in PCT at the moment of septic complications compared with concentrations measured 1 day before the diagnosis of sepsis: 0.85 vs. 3.32 ng/mL for PCT (p < 0.001) and 135 vs. 175 mg/L for CRP (p = not significant). The areas under the respective curve at admission in the diagnosis of sepsis were 0.787 (p < 0.001) and 0.489 for PCT and CRP, respectively.
  
  
  CONCLUSIONS
  PCT plasma reinduction marks possible septic complication during systemic inflammatory response syndrome after major trauma. In addition, high PCT concentration at admission after trauma in ICU patients indicates an increased risk of septic complications.
authors.affiliation: Department of Anaesthesiology, Intensive Care Therapy and Pain Relief, Mantova, Italy. gianpaolo.castelli@libero.it
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Castelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Pognani
authors.forename: Massimo
authors.initials: M
authors.lastname: Cita
authors.forename: Rolando
authors.initials: R
authors.lastname: Paladini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D014947:Wounds and Injuries / Q000097:blood* / Q000150:complications*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide