title: Serum procalcitonin predicting mortality in exertional heatstroke.
abstract: BACKGROUND
  The aim of this study was to test if Procalcitonin PCT value at the time of admission is a predictor of mortality and/or a diagnostic marker of concomitant infection in exertional heatstroke.
  
  
  METHODS
  68 patients with exertional heatstroke admitted to the multidisciplinary intensive care unit were studied. Serum PCT was detected by means of a specific and ultrasensitive immunoluminometric assay within 2 h of admission. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was evaluated within 24 h of admission.
  
  
  RESULTS
  There was no significant difference in PCT levels between concomitant infection and non-infection patients (p=0.712). Elevated PCT level in exertional heatstroke patients was associated with a more critical pathological state. PCT values in patients with multiple organ dysfunction syndrome (MODS) were significantly higher than those without MODS (p=0.007.). PCT values were also positively correlated with APACHE II scores (r=0.588, p=0.016). PCT values in non-survivors were higher than in survivors at univariate regression analysis (p=0.017). After adjusting for confounders, PCT concentration also remained an independent determinant of mortality (OR 2.98; 95% CI 1.02 to 4.41; p=0.039). Receiver operating characteristic curve for PCT concentration was located above the reference line, which shows an association with mortality. The area under the curve for PCT concentration (0.705; 95% CI 0.547 to 0.862) was statistical significantly (p=0.019). As a predictor of mortality, PCT value was inferior to APACHE II score.
  
  
  CONCLUSIONS
  PCT value at the time of admission is an independent predictor of mortality, but maybe not a good indicator of concomitant infection in exertional heatstroke.
authors.affiliation: ICU, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China.
authors.forename: Hua-Sheng
authors.initials: HS
authors.lastname: Tong
authors.forename: Yun-Song
authors.initials: YS
authors.lastname: Liu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wen
authors.forename: You-Qing
authors.initials: YQ
authors.lastname: Tang
authors.forename: Fang-Fang
authors.initials: FF
authors.lastname: Yuan
authors.forename: Lei
authors.initials: L
authors.lastname: Su
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001831:Body Temperature / Q000502:physiology; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002681:China; D018883:Heat Stroke / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D005082:Physical Exertion / Q000502:physiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide