Can emergency physicians identify a high mortality subgroup of patients with sepsis: role of procalcitonin

• DOI: 10.1097/mej.0b013e3280ec539b
• Publication Date: 2009-03-05T04:47:39Z
• Authors: Alain Viallon; Stéphane Guyomarcʼh; Olivier Marjollet; Christophe Berger; Anne Carricajo; Florianne Robert; Sylvie Laporte; Claude Lambert; Yves Page; Fabrice Zéni; Jean Claude Bertrand
• Keywords: Procalcitonin; Bacteremia

To assess the potential role of procalcitonin and tumor necrosis factor-alpha, interleukin-6 interleukin-8, in prognosis patients with sepsis.Prospective study.The emergency unit a teaching hospital.We included 131 sepsis: 15 (12%) septic shock, 20 (15%) severe sepsis 96 (73%) sepsis.Out patients, 112 (85.5%) survived 19 (14.5%) died. These two groups differed regard to simplified acute physiology score II, severity infectious disease underlying disease, bacteremia type microorganisms. The mean serum levels factor, interleukin-6, lactates at study entry were higher nonsurvivors than survivors. Multivariate regression analysis showed most significant these variables be level (P=0.0007), II (P=0.03) lactate (P=0.03). Using model incorporating three variables, cut-off value corresponding 15% probability predicting mortality, death could correctly predicted 99.5% cases survival 95%. This allowed us maximize prediction death. When not taken into account, best levels, but rate correct then dropped 84%.Stepwise multivariate logistic valuable marker severity, compared other clinical, biochemical bacteriologic tested.