title: [Prognostic value of procalcitonin, C-reactive protein and leukocytes in septic shock].
abstract: OBJECTIVE
  This study evaluates the potential prognostic value of serial measurements of different biomarkers (procalcitonin [PCT], C-reactive protein and leukocytes [CRP]) in septic shock patients.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Intensive care unit of a third-level University Hospital.
  
  
  METHODS
  The study comprised a total of 88 septic shock patients defined using the 2001 Consensus Conference SCCM/ESICM/ACCP/ATS/SIS criteria. The PCT, CRP and leukocytes were recorded on admission to the ICU and again 72 hours after admission.
  
  
  METHODS
  None.
  
  
  RESULTS
  Those patients with increasing procalcitonin levels showed higher hospital mortality than those with a decreasing levels (58.8% vs. 15.4%, P<0.01). No such effect was observed in relation to C-reactive protein or leukocytes. The best area under the curve for prognosis was for procalcitonin clearance (0.79). A procalcitonin clearance of 70% or higher offered a sensitivity and specificity of 94.7% and 53%, respectively.
  
  
  CONCLUSIONS
  Serial procalcitonin measurements are more predictive of the prognosis of septic shock patients than single measurements of this parameter. The prognostic reliability of the latter is also better than in the case of C-reactive protein and leukocytes. The application of serial procalcitonin measurements may allow the identification of those septic patients at increased mortality risk, and help improve their treatment.
authors: Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España. bsuberviola@yahoo.es
authors: B
authors: B
authors: Suberviola
authors: A
authors: A
authors: Castellanos-Ortega
authors: A
authors: A
authors: González-Castro
authors: L A
authors: LA
authors: García-Astudillo
authors: B
authors: B
authors: Fernández-Miret
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D015897:Comorbidity; D003953:Diagnosis-Related Groups; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012306:Risk; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide