Key result
Serum procalcitonin levels on day 3 accurately predicted all-cause mortality in critically ill pediatric patients, demonstrating an area under the curve of 0.928.
Why the study?
Although serum procalcitonin is a known marker in serious bacterial infection, the study aimed to evaluate serial procalcitonin levels to determine whether it can predict mortality in critically ill pediatric patients.
Does serial serum procalcitonin measurement predict mortality in critically ill children admitted to the PICU?
Observational (n=185)
No
Does serial serum procalcitonin measurement predict mortality in critically ill children admitted to the PICU?
Effect estimate: AUC 0.928 (95% CI 0.877-0.963)
p-value: p=<0.0001
Serial serum procalcitonin monitoring, particularly on day 3, is a strong prognostic marker for all-cause mortality in critically ill pediatric patients, outperforming the PRISM-3 score.
Day-3 procalcitonin may aid mortality prediction in critically ill children; hypothesis-generating and requires prospective validation.
Background: Serum procalcitonin (PCT) is already known predictive marker in serious bacterial infection and it is emphasized that these biomarkers can be used as a marker of increased mortality in critically ill patients. The aim of the study was to evaluate the serial PCT level and find out whether these biomarkers can be used to predict mortality. Methods: This was a prospective observational study. Primary objective was to study the serum PCT as a prognostic marker in critically ill children (2 months to 12 years) admitted in PICU while secondary objective was to find out the association of level of serum procalcitonin with different organ system disease involvement and to compare the results of the serum procalcitonin with the PRISM-3 score in diagnosing the severity of illness in the patient. Patient outcome was assessed at hospital discharge, and the patients were divided into non-survivors and survivors. A p value of <0.05 will be considered statistically significant. Results: A total of 185 patients were enrolled, the median age was 5 years (2 months to 12 years) with 56.76% being males. Majority (34.59%) of patients the primary diagnosis was of respiratory system. The median of serum PCT on day 1, day 3 and day 7 with outcome (p<0.05) in dead was significantly higher as compared to alive. The median PRISM score in dead was 21(13-33) which was significantly higher as compared to alive 11 (8-12.7). Serum PCT and PRISM score had significant discriminatory power to predict mortality. Conclusions: In the present study serum PCT found to be a good prognostic marker for all cause mortality in critically ill patients admitted in PICU.
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Kumar et al. (2023) conducted an observational in Critically ill children (n=185). Serum procalcitonin (PCT) level vs. Survivors (lower PCT levels) was evaluated on Mortality prediction (AUC of serum PCT on day 3) (AUC 0.928, 95% CI 0.877-0.963, p=<0.0001). Serum procalcitonin levels on day 3 accurately predicted all-cause mortality in critically ill pediatric patients, demonstrating an area under the curve of 0.928.
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