Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study.
Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study.
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DOI：
10.1186/cc9327
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Finnsepsis Study Group
中科院分区：
文献类型：
--
作者：
Karlsson S;Heikkinen M;Pettilä V;Alila S;Väisänen S;Pulkki K;Kolho E;Ruokonen E;Finnsepsis Study Group
这项前瞻性研究调查了降钙素原（PCT）对242例重症监护治疗的严重脓毒症和脓毒性休克成人患者生存率的预测价值。在基线时对所有患者的血液样本进行PCT分析，72小时后对155例患者进行PCT分析。第0天的中位PCT血清浓度为5.0 ng/ml（四分位距（IQR）1.0和20.1 ng/ml），72小时后为1.3 ng/ml（IQR 0.5和5.8 ng/ml）。住院死亡率为25.6%（62/242）。社区获得性感染患者的中位PCT浓度高于医院感染患者（P = 0.001）。28.5%的患者（n = 69）血培养阳性，与阴性培养相比，血培养阳性的严重脓毒症与更高的PCT水平相关（P = < 0.001）。感染性休克患者的PCT浓度高于无感染性休克患者（P = 0.02）。PCT浓度在医院存活者和非存活者之间没有差异（分别为P = 0.64和P = 0.99），但PCT浓度下降> 50%（72小时）的患者死亡率低于下降<50%的患者（12.2% vs. 29.8%，P = 0.007）。PCT浓度在更严重形式的严重脓毒症中更高，但实质性浓度降低对生存比绝对值更重要。
This prospective study investigated the predictive value of procalcitonin (PCT) for survival in 242 adult patients with severe sepsis and septic shock treated in intensive care. PCT was analyzed from blood samples of all patients at baseline, and 155 patients 72 hours later. The median PCT serum concentration on day 0 was 5.0 ng/ml (interquartile range (IQR) 1.0 and 20.1 ng/ml) and 1.3 ng/ml (IQR 0.5 and 5.8 ng/ml) 72 hours later. Hospital mortality was 25.6% (62/242). Median PCT concentrations in patients with community-acquired infections were higher than with nosocomial infections (P = 0.001). Blood cultures were positive in 28.5% of patients (n = 69), and severe sepsis with positive blood cultures was associated with higher PCT levels than with negative cultures (P = < 0.001). Patients with septic shock had higher PCT concentrations than patients without (P = 0.02). PCT concentrations did not differ between hospital survivors and nonsurvivors (P = 0.64 and P = 0.99, respectively), but mortality was lower in patients whose PCT concentration decreased > 50% (by 72 hours) compared to those with a < 50% decrease (12.2% vs. 29.8%, P = 0.007). PCT concentrations were higher in more severe forms of severe sepsis, but a substantial concentration decrease was more important for survival than absolute values.
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影响因子：
3.7
作者：
Charles PE;Ladoire S;Aho S;Quenot JP;Doise JM;Prin S;Olsson NO;Blettery B
通讯作者：
Blettery B
DOI：
10.1186/cc7903
发表时间：
2009
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hochreiter M;Köhler T;Schweiger AM;Keck FS;Bein B;von Spiegel T;Schroeder S
通讯作者：
Schroeder S
影响因子：
15.1
作者：
Meisner, M;Tschaikowsky, K;Schmidt, J
通讯作者：
Schmidt, J
影响因子：
8.8
作者：
Kumar, Arland;Roberts, Daniel;Cheang, Mary
通讯作者：
Cheang, Mary
影响因子：
120.7
作者：
LEGALL, JR;LEMESHOW, S;SAULNIER, F
通讯作者：
SAULNIER, F