title: [Levels and prognostic significance of serum procalcitonin and D-dimer in children with systemic inflammatory response syndrome].
abstract: OBJECTIVE
  To evaluate the prognostic significance of serum levels of procalcitonin (PCT) and D-dimer in children with systemic inflammatory response syndrome (SIRS).
  
  
  METHODS
  A prospective case control study was conducted on 67 pediatric patients with SIRS who were treated in the pediatric intensive care unit (PICU). Based on the presence or absence of infectious lesions, patients were categorized as sepsis and non-sepsis. Within 24 hours after admission, white blood cell (WBC) count and serum levels of PCT, C-reactive protein (CRP) and D-dimer were determined, and the pediatric critical illness score (PCIS) was calculated. The correlation of PCIS with each of the other measurements was analyzed. On day 28 of follow-up, receiver operator characteristic (ROC) curve was plotted, and the area under ROC (AUC) was calculated. 28-day survival was estimated. Multivariate logistic regression analysis was performed to identify independent risk factors for in-hospital mortality.
  
  
  RESULTS
  Serum levels of PCT and D-dimer were significantly higher (P<0.05) but PCIS was significantly lower (P<0.05) in patients with sepsis than in those without sepsis. Both PCT and D-dimer were negatively correlated with PCIS (P<0.01). Serum levels of PCT and D-dimer 24 hours after admission were higher (P<0.05) and PCIS was lower (P<0.05) in non-survivors than in survivors on day 28. AUC was 0.875, 0.872 and 0.863 respectively for PCT, D-dimer and PCIS in the prediction of 28-day survival (P<0.01). Logistic regression analysis revealed that PCT and D-dimer were independent prognostic factors (odd ratio: 1.684 and 1.003; P<0.01).
  
  
  CONCLUSIONS
  Serum levels of PCT may be helpful in differentiating sepsis and non-sepsis at early stage of SIRS in children. PCT and D-dimer are independent risk factors for in-hospital mortality in children with SIRS, and thus have a prognostic significance in clinical settings.
authors.affiliation: Pediatric Intensive Care Unit, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China. qyz1972qyz@sina.com.
authors.forename: Ying-Zheng
authors.initials: YZ
authors.lastname: Qi
authors.forename: Duolikun
authors.initials: D
authors.lastname: Muzhaper
mesh_terms: D000293:Adolescent; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000401:mortality
chemical_list: C000606589:CALCA protein, human; D005338:Fibrin Fibrinogen Degradation Products; D011498:Protein Precursors; C036309:fibrin fragment D; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide