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Dynamic Change of Procalcitonin, Rather Than Concentration Itself, Is Predictive of Survival in Septic Shock Patients When beyond 10ng/mL.
MedLine Citation:
PMID:  21937947     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Procalcitonin (PCT) concentration greater than 10ng/mL is compatible for septic shock. Its predictive value for survival is not well established, mainly due to much overlap and variation of PCT in this condition. We hypothesized that dynamic change of PCT, rather than PCT itself, is predictive of hospital survival when greater than 10ng/mL. Thirty seven septic shock patients with PCT concentration greater than 10ng/mL were enrolled in this prospective cohort study. Patients were divided into survivors (N=25) and non-survivors (N=12) based on 28-day hospital outcome. Subsequent PCT measurements were taken 5 days after enrollment. Sequential organ failure assessment (SOFA) score were recorded simultaneously. Dynamic change of PCT and SOFA score were defined as the difference between the subsequent and initial measurement. There were no significant difference between survivors and nonsurvivors in age, sex, initial measurement of PCT and SOFA. All survivors had a decrease of PCT concentration, median decrease was 9.73ng/mL. All nonsurvivors had an increase of PCT concentration, median increase was 5.95ng/mL. Significant decrease of PCT concentration (>25%) was observed in all the 25 survivors while none in 12 nonsurvivors. PCT of initial, subsequent measurements, and dynamics significantly correlated with their counterparts of SOFA score. In conclusion, significant decrease of PCT concentration, rather than PCT concentration itself, may be a useful indicator of survival in septic shock patients when PCT concentration is greater than 10ng/mL. PCT concentration highly correlated with SOFA score in septic shock patients even when PCT concentration is above 10ng/mL.
Authors:
Jun Guan; Zhaofen Lin; Hong Lue
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-7
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China 2Taicang Chinese Medicine Hospital, Taicang, Jiangsu Province, China.
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