Prognostic accuracy of procalcitonin and other biomarkers in septic shock patient in PICU
Keywords:
septic shock, sepsis, CRP, procalcitonin, CRP/albumin ratio, culture resultAbstract
Background and aim: Septic shock is one of the main causes of sepsis. Sepsis is a life-threatening acute systemic inflammatory response to infection. Many studies have tested the usefulness of biomarkers of sepsis prognosis in PICU patients. This study aims to prove that CRP, procalcitonin, CRP/albumin ratio, and culture results, are prognostic markers of mortality in pediatric sepsis shock patients.
Methods: A retrospective with cross-sectional study design using the medical records of critically ill children with septic shock aged 1 month to 18 years, admitted to the PICU of Dr. Soetomo Hospital from February 2022 to July 2023. The inclusion criteria were patient with sepsis shock were reviewed for laboratory results and clinical conditions from the time of admission until 30 days after PICU treatment. Patients with incomplete data, patients with AKI stage failure or loss, chronic renal failure, autoimmune diseases, malignancy, trauma (burns, fractures, surgery), heart disease, and HIV patients could not participate in the study.
Results: A total of ninety-six medical records of critically ill sepsis patients in PICU were observed, only 69 patients were followed up, and 27 patients were excluded. A total of 33 (47.8%) patients died, most patients died in the age group of 1-12 months (51.5%) and male (81.9%). There was a significant association between sex and mortality in septic shock children, with being female increases the chance to survive by 3.600-time, 95% CI [1.196010.838], P=0.023. There was a significant association between PCT levels and mortality of sepsis shock patients (P=0.041). There was no significant difference between CRP levels, CRP/albumin ratio (CAR), and culture results with patient mortality status.
Conclusions: Procalcitonin is superior as a prognostic biomarker of mortality in critically ill patients with sepsis shock, compared to CRP, CRP/albumin ratio, and culture.
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