[Usefulness of procalcitonin upon admission to intensive care in the diagnosis and prognosis of sepsis].
OBJECTIVE
To assess the usefulness of procalcitonin (PCT) upon admission to the Intensive Care Unit (ICU) in the diagnosis and prognosis of sepsis


METHODS
A 12-month prospective observational cohort study was carried out


METHODS
An 11-bed polyvalent ICU Belonging to a University hospital


METHODS
Fifty patients with systemic inflammatory response syndrome (SIRS) were included. The mean age of the patients was 51.66 years, and 68% of them were males


METHODS
Upon admission, the concentration of PCT and C-reactive protein (CRP) was assessed. At discharge, the final diagnosis and outcome were reviewed


RESULTS
Thirty-six patients had sepsis. Mean PCT ± SD was higher in sepsis than in non-infectious SIRS (19.3 ± 4.9 vs. 0.65 ± 0.2) ng/ml) (P=.001). PCT had greater discriminating power than CRP (AUC 0.932 vs. 0.827). The cut-off value of PCT for the diagnosis of sepsis was 0.92 ng/dl, with a sensitivity of 80.56%, specificity 85.71%, positive predictive value 93.55% and negative predictive value 63.16%, LR+ 5.64 and LR- 0.23. Mortality was higher in patients with sepsis (52.78% vs. 21.43%) (P=.039). Mean PCT ± SD upon admission among survivors and deceased patients with sepsis was 18.7 ± 6.7 and 19.5 ± 7.5 ng/ml, respectively (P=.934).


CONCLUSIONS
PCT upon admission to the ICU is useful for the diagnosis of sepsis, and is more effective than PCR in this respect. However, it is of no help in estimating the short-term prognosis.
Unidad de Terapia Intensiva, Hospital Escuela Eva Perón, Granadero Baigorria (Gran Rosario), Santa Fe, Argentina. morettidino@hotmail.com
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D000328:Adult; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis*
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide