Low procalcitonin clearance correlates with mortality treated with culture-matched antibiotics in intensive care unit: A retrospective, observational study

Abstract

Background: Sepsis is a clinical syndrome with a high mortality rate which shows a direct relationship with the severity of the disease. Changes in procalcitonin levels in several studies are considered indicators of bacterial infection. The goal of this study was to prove that low procalcitonin clearance is a mortality predictor in sepsis patients who are given antibiotics in the intensive care unit. Materials and Methods: This was an analytic, observational, retrospective study, with a cross-sectional design. The study was conducted by taking medical record data of sepsis patients who were treated with culture-specific antibiotics and then collecting data on changes in procalcitonin levels on the first day and 72 h antibiotics administration per antibiotic-sensitivity results. Patients were grouped with procalcitonin clearance <70% and ≥70% and were associated with survive and mortality groups. Data were analyzed by chi-square test. Results: There were 116 sepsis patients with an average age of 48.92 years. Most of the patients were aged 18–65 years (86.2%), with male predominance (72.4%). In this study, we found 68 patients (58.6%) with procalcitonin clearance ≥70%, whereas 48 patients (41.4%) had procalcitonin clearance <70%. The 28-day mortality in patients with procalcitonin clearance <70% (66.7%) was higher than in patients with procalcitonin clearance ≥70% (47.1%). There was a significant relationship between procalcitonin clearance <70% and the 28-day mortality outcome in septic patients who were given antibiotics according to culture (P = 0.036). Conclusion: Low procalcitonin clearance was significantly associated with 28-day mortality outcome in septic patients. Further studies are needed to gain a better understanding of this matter.

Keywords

• mortality
• procalcitonin clearance
• sepsis