Key result
Serum procalcitonin levels at 48-72 hours demonstrated high predictive validity for in-hospital mortality in pediatric patients after surgical infection, with an area under the curve of 0.89.
Why the study?
Procalcitonin levels rise with systemic inflammation, but its utility as a single biomarker to predict mortality in pediatric patients following acute trauma or post-surgical infection needed evaluation.
Does procalcitonin level predict in-hospital mortality in pediatric patients after acute traumatic or post-surgical infections?
Cohort (n=245)
No
Does procalcitonin level predict in-hospital mortality in pediatric patients after acute traumatic or post-surgical infections?
Effect estimate: AUC 0.89 (95% CI 0.85-0.93)
p-value: p=<0.001
Serum procalcitonin level at 48-72 hours is a highly predictive biomarker for in-hospital mortality in critically ill pediatric patients following surgical infection or trauma.
May support mortality risk stratification in critically ill children with post-traumatic/surgical infection; hypothesis-generating and requires prospective validation.
Background Procalcitonin (PCT) levels are elevated in pediatric patients with systemic inflammation. This study was aimed to evaluate the use of Procalcitonin as a single biomarker in the prediction of mortality in pediatric patients after acute traumatic events or post-surgical infection. Methods This retrospective longitudinal study involved pediatric patients aged more than two weeks who were admitted to Pediatric Intensive Care Unit (PICU) of King Fahd Hospital of the University from January 2017 to December 2019 due to post-surgical infection. The data includes age, gender, comorbidity, severity of trauma, Pediatric Risk of Mortality Score (PRISM III) score in 24h of admission, PCT level at 24h and 48-72h, day-5 admission, blood culture, PICU stay, multi-organ failure, number of inotropes and intubation requirement were retrieved. Results The mortalities after surgical infection was of 15.9%. Significantly, the elevated mean levels including PRISM III score, PCT level at 24h, 48-72h and day-5 admission were found in patients who were expired during their hospital stay. The PCT level at 48-72h was 0.89 (best cutoff point >1.35) revealed as highly predictive validity of PCT compared to PCT level at 24h which was 0.76 (best cutoff point >0.15) respectively. Conclusion The serum PCT level as a single laboratory biomarker is remarkably useful in the prediction of mortality after surgical infection for commencing of an earliest treatment plan as a lifesaving attempt. A blended approach based on the PCT level with other clinical biomarkers can be developed for monitoring a treatment given.
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Waleed H. Albuali (2021) conducted a cohort in Acute traumatic or post-surgical infections (n=245). Procalcitonin (PCT) level was evaluated on Prediction of in-hospital mortality (AUC 0.89, 95% CI 0.85-0.93, p=<0.001). Serum procalcitonin levels at 48-72 hours demonstrated high predictive validity for in-hospital mortality in pediatric patients after surgical infection, with an area under the curve of 0.89.
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