title: Usefulness of procalcitonin clearance as a prognostic biomarker in septic shock. A prospective pilot study.
abstract: OBJECTIVE
  To evaluate procalcitonin clearance as a prognostic biomarker in septic shock.
  
  
  METHODS
  Prospective, observational pilot study.
  
  
  METHODS
  Intensive care unit.
  
  
  METHODS
  Patients admitted to the ICU due to septic shock and multiorgan dysfunction.
  
  
  METHODS
  Serum concentrations of procalcitonin were determined within 12h of onset of septic shock and multiorgan dysfunction (coinciding with admission to the ICU), and the following extractions were obtained after 24, 48 and 72h in patients who survived.
  
  
  METHODS
  Demographic data, Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score, data on the primary focus of infection, and patient outcome (ICU mortality).
  
  
  RESULTS
  Procalcitonin clearance was higher in survivors than in non-survivors, with significant differences at 24h (73.9 [56.4-83.8]% vs 22.7 [-331-58.4], p<0.05) and 48h (81.6 [71.6-91.3]% vs -7.29 [-108.2-82.3], p<0.05). The area under the ROC curve was 0.74 (95%CI, 0.54-0.95, p<0.05) for procalcitonin clearance at 24h, and 0.86 (95%CI, 0.69-1.0, p<0.05) at 48h.
  
  
  CONCLUSIONS
  ICU mortality was associated to sustained high procalcitonin levels, suggesting that procalcitonin clearance at 48h may be a valuable prognostic biomarker.
authors.affiliation: Servei de Medicina Intensiva, Universitat Autònoma de Barcelona, Barcelona,, Spain. jcruiz@vhebron.net
authors.forename: J C
authors.initials: JC
authors.lastname: Ruiz-Rodríguez
authors.forename: J
authors.initials: J
authors.lastname: Caballero
authors.forename: A
authors.initials: A
authors.lastname: Ruiz-Sanmartin
authors.forename: V J
authors.initials: VJ
authors.lastname: Ribas
authors.forename: M
authors.initials: M
authors.lastname: Pérez
authors.forename: J L
authors.initials: JL
authors.lastname: Bóveda
authors.forename: J
authors.initials: J
authors.lastname: Rello
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood* / Q000401:mortality*; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide