title: Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis.
abstract: BACKGROUND To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis. MATERIAL AND METHODS A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson's correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients' death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis. RESULTS The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson's correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77-0.88), 0.76 (95% CI, 0.70-0.82), and 0.73 (95% CI, 0.67-0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87-0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001). CONCLUSIONS The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.
authors.affiliation: Department of Pediatrics, People's Hospital of China Three Gorges University, The 1st People's Hospital of Yichang, Yichang, Hubei, China (mainland).
authors.forename: Qiong
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Cardiothoracic Surgery, People's Hospital of China Three Gorges University, The 1st People's Hospital of Yichang, Yichang, Hubei, China (mainland).
authors.forename: Jun
authors.initials: J
authors.lastname: Nie
authors.affiliation: Department of Pediatrics, People's Hospital of China Three Gorges University, The 1st People's Hospital of Yichang, Yichang, Hubei, China (mainland).
authors.forename: Fu-Xia
authors.initials: FX
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, People's Hospital of China Three Gorges University, The 1st People's Hospital of Yichang, Yichang, Hubei, China (mainland).
authors.forename: Xiu-Lan
authors.initials: XL
authors.lastname: Zou
authors.affiliation: Department of Pediatrics, People's Hospital of China Three Gorges University, The 1st People's Hospital of Yichang, Yichang, Hubei, China (mainland).
authors.forename: Feng-Yi
authors.initials: FY
authors.lastname: Chen
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D051847:Lithostathine / Q000097:blood*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D018805:Sepsis / Q000097:blood* / Q000401:mortality
chemical_list: D051847:Lithostathine; D002116:Calcitonin; D002097:C-Reactive Protein