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Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis

View Article: PubMed Central - PubMed

ABSTRACT

Background: To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis.

Material/methods: A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson’s correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients’ death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis.

Results: The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson’s correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77–0.88), 0.76 (95% CI, 0.70–0.82), and 0.73 (95% CI, 0.67–0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87–0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001).

Conclusions: The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.

No MeSH data available.


Pancreatic stone protein expression and ROC analysis in 28-day mortality. (A) PSP expression in the two groups; (B) ROC analysis of PSP in 28-day mortality. Cutoff value for PSP is 256 ng/L. PSP – pancreatic stone protein; * p<0.01, compared with survival.
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f4-medscimonit-23-1533: Pancreatic stone protein expression and ROC analysis in 28-day mortality. (A) PSP expression in the two groups; (B) ROC analysis of PSP in 28-day mortality. Cutoff value for PSP is 256 ng/L. PSP – pancreatic stone protein; * p<0.01, compared with survival.

Mentions: The serum concentrations of PCT, hs-CRP, and PSP were higher in the dying group of patients (p<0.01; Figures 2–4). To further determine the prognostic value of the three markers in children with sepsis, receiver operating characteristic (ROC) curves were used to evaluate the predictive power. The results indicated that area under the curve (AUC) values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77–0.88), 0.76 (95% CI, 0.70–0.82) and 0.73 (95% CI, 0.67–0.79), respectively. As illustrated in Table 3, the sensitivity and specificity of cutoff values were calculated according to ROC curve analysis. Subsequently, the ROC curve comparison revealed a higher prognostic value of PCT compared with hs-CRP and PSP (p<0.001) as shown in Figure 5. Multivariate logistic regression was conducted to calculate the coefficients of these biomarkers when used in predicting mortality in patients with sepsis (PCT & hs-CRP & PSP) = −12.3125 + 0.068404*PCT + 0.058065*hs-CRP + 0.012057*PSP. The results of ROC analysis of (PCT & hs-CRP & PSP) are shown in Table 3. The prognostic value of the combined PCT, hs-CRP, and PSP levels in children with sepsis was higher than the individual levels (p<0.001; Figure 5).


Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis
Pancreatic stone protein expression and ROC analysis in 28-day mortality. (A) PSP expression in the two groups; (B) ROC analysis of PSP in 28-day mortality. Cutoff value for PSP is 256 ng/L. PSP – pancreatic stone protein; * p<0.01, compared with survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5384617&req=5

f4-medscimonit-23-1533: Pancreatic stone protein expression and ROC analysis in 28-day mortality. (A) PSP expression in the two groups; (B) ROC analysis of PSP in 28-day mortality. Cutoff value for PSP is 256 ng/L. PSP – pancreatic stone protein; * p<0.01, compared with survival.
Mentions: The serum concentrations of PCT, hs-CRP, and PSP were higher in the dying group of patients (p<0.01; Figures 2–4). To further determine the prognostic value of the three markers in children with sepsis, receiver operating characteristic (ROC) curves were used to evaluate the predictive power. The results indicated that area under the curve (AUC) values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77–0.88), 0.76 (95% CI, 0.70–0.82) and 0.73 (95% CI, 0.67–0.79), respectively. As illustrated in Table 3, the sensitivity and specificity of cutoff values were calculated according to ROC curve analysis. Subsequently, the ROC curve comparison revealed a higher prognostic value of PCT compared with hs-CRP and PSP (p<0.001) as shown in Figure 5. Multivariate logistic regression was conducted to calculate the coefficients of these biomarkers when used in predicting mortality in patients with sepsis (PCT & hs-CRP & PSP) = −12.3125 + 0.068404*PCT + 0.058065*hs-CRP + 0.012057*PSP. The results of ROC analysis of (PCT & hs-CRP & PSP) are shown in Table 3. The prognostic value of the combined PCT, hs-CRP, and PSP levels in children with sepsis was higher than the individual levels (p<0.001; Figure 5).

View Article: PubMed Central - PubMed

ABSTRACT

Background: To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis.

Material/methods: A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson&rsquo;s correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients&rsquo; death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis.

Results: The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p&lt;0.001). Pearson&rsquo;s correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p&lt;0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p&lt;0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77&ndash;0.88), 0.76 (95% CI, 0.70&ndash;0.82), and 0.73 (95% CI, 0.67&ndash;0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87&ndash;0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p&lt;0.001).

Conclusions: The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.

No MeSH data available.