title: Procalcitonin Is a Stronger Predictor of Long-Term Functional Outcome and Mortality than High-Sensitivity C-Reactive Protein in Patients with Ischemic Stroke.
abstract: Inflammatory markers have been associated with functional outcome and mortality of stroke. We investigated the changes in procalcitonin (PCT) and high-sensitivity C-reactive protein (Hs-CRP) levels during the acute period of ischemic stroke and evaluated the relationship between these levels and the long-term functional outcome and mortality. We prospectively studied 376 patients with acute ischemic stroke (AIS) who were admitted within 24 h after the onset of symptoms. PCT, Hs-CRP, and NIH Stroke Scale (NIHSS) were measured at the time of admission. Long-term functional outcome were measured by modified Rankin scale (mRS) at 1 year after admission. The correlations between the levels of PCT, Hs-CRP, and mortality at 1 year after stroke onset were analyzed. Patients with poor with functional outcome and non-survivors had significantly increased PCT and Hs-CRP levels on admission. Multivariate logistic regression analysis showed that PCT was an independent prognostic marker of 1-year functional outcome and death [odds ratio (OR) 2.33 (95% CI, 1.33-3.44) and 3.11 (2.02-4.43), respectively, P < 0.0001 for both, adjusted for age, NIHSS, other predictors, and vascular risk factors] in patients with AIS. The area under the receiver operating characteristic curve of PCT was 0.77 (95% CI, 0.72-0.83) for functional outcome and 0.88 (95% CI, 0.84-0.93) for mortality. PCT improved the area under the receiver operating characteristic curve of the NIHSS score for functional outcome from 0.74 (95% CI, 0.66-0.81) to 0.85 (95% CI, 0.76-0.92; P < 0.0001) and for mortality from 0.77 (95% CI, 0.70-0.83) to 0.94 (95% CI, 0.89-0.97; P < 0.0001). Serum level of PCT at admission was an independent predictor of long-term functional outcome and mortality after ischemic stroke in Chinese sample.
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Chao
authors: C
authors: Wang
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Li
authors: L
authors: Gao
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Zhi-Guo
authors: ZG
authors: Zhang
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Yu-Qian
authors: YQ
authors: Li
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Yan-Long
authors: YL
authors: Yang
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Tao
authors: T
authors: Chang
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Long-Long
authors: LL
authors: Zheng
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Xing-Ye
authors: XY
authors: Zhang
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China.
authors: Ming-Hao
authors: MH
authors: Man
authors: Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, No. 1, Xinsi Road, Baqiao District, Xi'an, Shaanxi Province, 710038, People's Republic of China. swiculh1@fmmu.edu.cn.
authors: Li-Hong
authors: LH
authors: Li
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers; D002545:Brain Ischemia / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: Acute ischemic stroke; Functional outcome; High-sensitivity C-reactive protein; Mortality; Procalcitonin
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