Korean J Anesthesiol.  2017 Jun;70(3):305-310. 10.4097/kjae.2017.70.3.305.

The prognostic value of procalcitonin, C-reactive protein and cholesterol in patients with an infection and multiple organ dysfunction

• Tachyla SA
• Marochkov
• Lipnitski
• Nikiforova YG

• KMID: 2382747
• DOI: http://doi.org/10.4097/kjae.2017.70.3.305

Abstract

BACKGROUND
To establish the prognostic value of procalcitonin, C-reactive protein and cholesterol levels for mortality in patients with an infection and multiple organ dysfunction.
METHODS
A prospective case-control study was performed, including 67 patients admitted to the intensive care unit with an infection and multiple organ dysfunction in whom cholesterol, procalcitonin, and C-reactive protein levels were measured on admission and during the course of treatment.
RESULTS
The associations between in-hospital mortality and procalcitonin, C-reactive protein, and cholesterol levels were analyzed. Logistic regression analysis showed that cholesterol (odds ratio [OR], 1.858; 95% CI, 1.170-2.949; P = 0.009) and C-reactive protein (OR, 4.408; 95% CI, 2.019-9.624; P < 0.001) levels were predictors of mortality. A receiver operating characteristic curve analysis yielded an area under the curve (AUC) of 0.774 and 95% CI of 0.693-0.855 (P < 0.001) for C-reactive protein, an AUC of 0.66 and 95% CI of 0.535-0.784 (P = 0.019) for procalcitonin, and an AUC of 0.654 and 95% CI of 0.593-0.715 (P < 0.001) for cholesterol as predictors of mortality. When combined with the bioscore system for mortality, these markers yielded an AUC of 0.845 and 95% CI of 0.770-0.921 (P < 0.001), with sensitivity of 89.1% and specificity of 83.1%.
CONCLUSIONS
The combination of procalcitonin, C-reactive protein, and cholesterol levels in a single scoring system yielded high predictive value for mortality.

Keyword

Cholesterol; C-reactive protein; Infection; Mortality; Multiple organ dysfunction; Procalcitonin

MeSH Terms

Area Under Curve
C-Reactive Protein*
Case-Control Studies
Cholesterol*
Hospital Mortality
Humans
Intensive Care Units
Logistic Models
Mortality
Prospective Studies
ROC Curve
Sensitivity and Specificity
C-Reactive Protein
Cholesterol