Hyperprocalcitonemia as a clinical prognosis in septic patients of private hospitals in the city of Cuenca–Ecuador
Abstract
Procalcitonin, an acute phase’s reactant, enables to establish sepsis-diagnosis’-patients status, bringing the possibility of associate it with its prognosis. The aim of this study was to determine the clinical prognosis of hyperprocalcitonemia in septical patients of private hospital centers in Cuenca–Ecuador. The study was cross-sectional, the sample were 207 patients. Data was analyzed with SPSS statistical program (25.0); analysis was done through descriptive statistic; association through Odds Ratio (OR), confidence interval (95%), considering statiscally significant values with p <0.05. Severe hyperprocalcitonemia prevalence was 63.29%, average age 67.25±19.07 years old; male sex prevailed 57% and half-blood ethnic group. A statistical association between severe hyperprocalcitonemia and longer hospital stay (≥15 days) was shown OR: 2.41 (CI 95% 1.11–5.19 p: 0.015); likewise, with in-hospital mortality OR: 9.37 (CI 95% 4.31–20.37 p: <0.000). Association was determined, but statistical significance with presence of comorbidities was not OR: 1.35 (CI 95% 0.69–2.64 p:0.243). Severe hyperprocalcitonemia was shown in almost 2/3 of patients, and there was an association with mortality increase and hospital stayReferences
Muñoz DGM. Procalcitonina en el diagnóstico temprano de sepsis de origen bacteriano. junio de 2006;XX(2):57–64.
Lee H. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med. 2013;28(3):285.
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. el 23 de febrero de 2016;315(8):801.
Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. el 23 de febrero de 2016;315(8):775.
Miguel-Bayarri V, Casanoves-Laparra EB, Pallás-Beneyto L, Sancho-Chinesta S, Martín-Osorio LF, Tormo-Calandín C, et al. Valor pronóstico de los biomarcadores procalcitonina, interleukina 6 y proteína C reactiva en la sepsis grave. Med Intensiva. noviembre de 2012;36(8):556–62.
Altunhan H, Annagür A, Örs R, Mehmetoğlu I. Procalcitonin measurement at 24 hours of age may be helpful in the prompt diagnosis of early-onset neonatal sepsis. Int J Infect Dis. 2011;15(12):e854–e858.
Mustafić S, Brkić S, Prnjavorac B, Sinanović A, Porobić Jahić H, Salkić S. Diagnostic and prognostic value of procalcitonin in patients with sepsis. Med Glas Off Publ Med Assoc Zenica-Doboj Cant Bosnia Herzeg. el 1 de agosto de 2018;15(2):93–100.
Moretti D, Ramírez MM, Settecase CJ, Bagilet DH, Quaglino MB. Valor de la procalcitonina al ingreso en terapia intensiva para el diagnóstico y el pronóstico de la sepsis. Med Intensiva. abril de 2013;37(3):156–62.
Evia JRB. Procalcitonina. Rev Mex Patol Clin. 2008;55(3):157–167.
Azevedo JRA de, Torres OJM, Czeczko NG, Tuon FF, Nassif PAN, Souza GD de. Procalcitonin as a prognostic biomarker of severe sepsis and septic shock. Rev Colégio Bras Cir. 2012;39(6):456–461.
Bayona ON, López AF, Cubells CL. Procalcitonina: una nueva herramienta diagnóstica en la infección bacteriana. Med Clínica. 2002;119(18):707–714.
Carrillo Esper R, Pérez Calatayud Á. Procalcitonina como marcador de procesos infecciosos en cirugía: Conceptos actuales. Cir Gen. 2013;35(1):49–55.
Zurita LAP, Dávila AP, Camporredondo IM. Procalcitonina como factor pronóstico de mortalidad en terapia intensiva. Acta Médica Grupo Ángeles. 2011;(1):7.
Liu D, Su L, Han G, Yan P, Xie L. Prognostic value of procalcitonin in adult patients with sepsis: a systematic review and meta-analysis. PloS One. 2015;10(6):e0129450.
Ahmed S, Siddiqui I, Jafri L, Hashmi M, Khan AH, Ghani F. Prospective evaluation of serum procalcitonin in critically ill patients with suspected sepsis- experience from a tertiary care hospital in Pakistan. Ann Med Surg 2012. noviembre de 2018;35:180–4.
Suberviola B, Castellanos-Ortega A, González-Castro A, García-Astudillo LA. Valor pronóstico del aclaramiento de procalcitonina, PCR y leucocitos en el shock séptico. 2012;3(36):177–84.
Liu YJ, Du P, Rao J. Procalcitonin as a diagnostic and prognostic marker for sepsis caused by intestinal infection: a case report. Eur Rev Med Pharmacol Sci. 2013;17(10):1311–1313.
Shi Y, Du B, Xu Y-C, Rui X, Du W, Wang Y. Early changes of procalcitonin predict bacteremia in patients with intensive care unit-acquired new fever. Chin Med J (Engl). 2013;126(10):1832–7.
Velandia Escobar JA, Bermudez Rivera EF, Romero Porras PC, Manrique Abril FG, Ospina Diaz JM. Valores de procalcitonina en pacientes diagnosticados como sepsis bacteriana en una Unidad de Cuidado Intensivo. Infectio. julio de 2014;18(3):86–92.
Wu R-X, Chiu C-C, Lin T-C, Yang Y-S, Lee Y, Lin J-C, et al. Procalcitonin as a diagnostic biomarker for septic shock and bloodstream infection in burn patients from the Formosa Fun Coast dust explosion. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi. diciembre de 2017;50(6):872–8.
Pérez MP, Chavarría AP, Sauceda A, Sánchez JA, Granillo JF. Índice procalcitonina/proteína C reactiva (PCT/PCR) como predictor de mortalidad en pacientes con choque séptico. :6.
Ochoa Parra M, Flores Enderica CG, Meneses Meneses MJ, Beltrán Zhindón MG, Arcentales Peralta MS, Bravo Genovéz AP, et al. Prevalencia de Infecciones en la Unidad de Cuidados Intensivos del Hospital José Carrasco Arteaga. Rev Médica Hosp José Carrasco Arteaga. el 20 de julio de 2016;8(2):137–41.
Peschanski N, Chenevier-Gobeaux C, Mzabi L, Lucas R, Ouahabi S, Aquilina V, et al. Prognostic value of PCT in septic emergency patients. Ann Intensive Care. 2016;6:47.
Ruiz-Rodríguez JC, Caballero J, Ruiz-Sanmartin A, Ribas VJ, Pérez M, Bóveda JL, et al. Usefulness of procalcitonin clearance as a prognostic biomarker in septic shock. A prospective pilot study. Med Intensiva. octubre de 2012;36(7):475–80.
Ríos-Toro JJ, Márquez-Coello M, García-Álvarez JM, Martín-Aspas A, Rivera-Fernández R, Sáez de Benito A, et al. Soluble membrane receptors, interleukin 6, procalcitonin and C reactive protein as prognostic markers in patients with severe sepsis and septic shock. PloS One. 2017;12(4):e0175254.
Yang XJ, Jin J, Xu H, Zhao DG, Sun X, Liu SL, et al. [Prognostic significance of serum procalcitonin in patients with extremely severe burn and sepsis]. Zhonghua Shao Shang Za Zhi Zhonghua Shaoshang Zazhi Chin J Burns. marzo de 2016;32(3):147–51.
Wang F, Hu G, Chen J, Gong Y, Yuan Z, Peng Y. [Prognostic significance of serum procalcitonin in patients with burn sepsis]. Zhonghua Shao Shang Za Zhi Zhonghua Shaoshang Zazhi Chin J Burns. junio de 2014;30(3):223–6.
Jain S, Sinha S, Sharma SK, Samantaray JC, Aggrawal P, Vikram NK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes. 2014;7(1):1.
Pupelis G, Drozdova N, Mukans M, Malbrain ML. Serum procalcitonin is a sensitive marker for septic shock and mortality in secondary peritonitis. Anaesthesiol Intensive Ther. 2014;46(4):262–273.
Huang X, Wang J, Li H. [Diagnostic and prognostic values of serum procalcitonin and C-reactive protein in patients of bacterial sepsis]. Zhonghua Yi Xue Za Zhi. el 15 de julio de 2014;94(27):2106–9.
Hur M, Kim H, Lee S, Cristofano F, Magrini L, Marino R, et al. Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis. BMC Infect Dis. 2014;14(1):1.
Pantoja-Chamorro F, Mazzillo-Vega L, Palacios-Barahona U. Análisis de la asociación entre procalcitonina y mortalidad por sepsis en menores de 18 años en una unidad de cuidados intensivos, Pasto- Colombia 2012 - 2014. Univ Salud. el 29 de diciembre de 2017;20(1):64.
Puyana JDP. Relación de niveles altos de procalcitonina y bacteremia durante las primeras 48 horas de infección. 2018;74.
Li Z, Wang H, Liu J, Chen B, Li G. Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study. Mediators Inflamm. 2014;2014:1–7.
Adamik B, Kübler-Kielb J, Golebiowska B, Gamian A, Kübler A. Effect of sepsis and cardiac surgery with cardiopulmonary bypass on plasma level of nitric oxide metabolites, neopterin, and procalcitonin: correlation with mortality and postoperative complications. Intensive Care Med. septiembre de 2000;26(9):1259–67.
Meng F-S, Su L, Tang Y-Q, Wen Q, Liu Y-S, Liu Z-F. Serum procalcitonin at the time of admission to the ICU as a predictor of short-term mortality. Clin Biochem. julio de 2009;42(10–11):1025–31.
Clec’h C, Fosse J-P, Karoubi P, Vincent F, Chouahi I, Hamza L, et al. Differential diagnostic value of procalcitonin in surgical and medical patients with septic shock. Crit Care Med. enero de 2006;34(1):102–7.
Magrini L, Travaglino F, Marino R, Ferri E, De Berardinis B, Cardelli P, et al. Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases. Eur Rev Med Pharmacol Sci. febrero de 2013;17 Suppl 1:133–42.
Kenzaka T, Okayama M, Kuroki S, Fukui M, Yahata S, Hayashi H, et al. Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis. Int J Gen Med. 2012;5:483–8.
Giamarellos-Bourboulis EJ, Tsangaris I, Kanni T, Mouktaroudi M, Pantelidou I, Adamis G, et al. Procalcitonin as an early indicator of outcome in sepsis: a prospective observational study. J Hosp Infect. enero de 2011;77(1):58–63.
Schuetz P, Birkhahn R, Sherwin R, Jones AE, Singer A, Kline JA, et al. Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients: Results From the Multicenter Procalcitonin MOnitoring SEpsis (MOSES) Study. Crit Care Med. mayo de 2017;45(5):781–9.
Li Q, Gong X. Clinical significance of the detection of procalcitonin and C-reactive protein in the intensive care unit. Exp Ther Med. mayo de 2018;15(5):4265–70.
Kim S-E. Serum Procalcitonin Is a Candidate Biomarker to Differentiate Bacteremia from Disease Flares in Patients with Inflammatory Bowel Disease. Gut Liver. el 15 de julio de 2016;10(4):491–2.
Pantelidou I-M, Giamarellos-Bourboulis EJ. Can procalcitonin monitoring reduce the length of antibiotic treatment in bloodstream infections? Int J Antimicrob Agents. diciembre de 2015;46:S10–2.
Hohn A, Schroeder S, Gehrt A, Bernhardt K, Bein B, Wegscheider K, et al. Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock. BMC Infect Dis. 2013;13(1):1.
Kim YK. Procalcitonin in bloodstream infections: beyond its role as a marker of clinical algorithm to reduce antimicrobial overuse. Korean J Intern Med. 2018;33(1):78–80.
Bréchot N, Hékimian G, Chastre J, Luyt C-E. Procalcitonin to guide antibiotic therapy in the ICU. Int J Antimicrob Agents. diciembre de 2015;46:S19–24.
Chu DC, Mehta AB, Walkey AJ. Practice Patterns and Outcomes Associated With Procalcitonin Use in Critically Ill Patients With Sepsis. Clin Infect Dis Off Publ Infect Dis Soc Am. el 1 de junio de 2017;64(11):1509–15.
Schuetz P, Maurer P, Punjabi V, Desai A, Amin DN, Gluck E. Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients. Crit Care. 2013;17(3):1.
Copyright (c) 2020 Zoila Katherine Torres, Diego Enrique Ledesma Pacurucu, Hermel Medardo Espinosa, Carlos Enrique Flores Montesinos, Lizette Espinosa Martin, Karla Alexandra Aspiazu Hinostroza, Patricia Michelle Martínez Salazar
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Kasmera journal is registered under a Creative Commons an Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0), available at: https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en; which guarantees the freedom to share-copy and redistribute the material in any medium or format and adapt-remix, transform and build from the material, provided that the name of the authors, the Department of Infectious and Tropical Diseases, Zulia´s University and Kasmera Journal, you must also provide a link to the original document and indicate if changes have been made.
The Department of Infectious and Tropical Diseases, University of Zulia and Kasmera Journal do not retain the rights to published manuscript and the contents are the sole responsibility of the authors, who retain their moral, intellectual, privacy and publicity rights. The guarantee on the intervention of the manuscript (revision, correction of style, translation, layout) and its subsequent dissemination is granted through a license of use and not through a transfer of rights, which represents the Kasmera Journal and Department Infectious Diseases, University of Zulia are exempt from any liability that may arise from ethical misconduct by the authors.
Kasmera is considered a green SHERPA/RoMEO journal, that is, it allows self-archiving of both the pre-print (draft of a manuscript) and the post-print (the corrected and peer-reviewed version) and even the final version (layout as it will be published in the journal) both in personal repositories and in institutional and databases.
_pequeño1.png)
_pequeña.png)
_pequeña.png)
_pequeña.jpg)
