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. 2017 Jun;70(3):305-310.
doi: 10.4097/kjae.2017.70.3.305. Epub 2017 Jan 11.

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

Siarhei Anatolevich Tachyla  1 , Alexey Viktorovich Marochkov  1 , Artur Leonidovich Lipnitski  1 , Yulia Gennadevna Nikiforova  1
Affiliations

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

Siarhei Anatolevich Tachyla et al. Korean J Anesthesiol. 2017 Jun.

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.

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

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Figures

Fig. 1
Fig. 1. Cholesterol levels in the two groups. *Significant differences between cholesterol levels in the first and second groups (P < 0.05).
Fig. 2
Fig. 2. Receiver operating characteristic curve for procalcitonin. AUC: area under the curve.
Fig. 3
Fig. 3. Receiver operating characteristic curve for C-reactive protein. AUC: area under the curve.
Fig. 4
Fig. 4. Receiver operating characteristic curve for cholesterol. AUC: area under the curve.
Fig. 5
Fig. 5. Receiver operating characteristic curve for the combined bioscore system for mortality in corporating procalcitonin, C-reactive protein and cholesteral. AUC: area under the curve.
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