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Author Tschaikowsky, Klaus ♦ Hedwig-Geissing, Monika ♦ Braun, Giovanni G. ♦ Radespiel-Troeger, Martin
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Surgery & related medical specialties ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Bacterial Infections and Mycoses ♦ Diseases ♦ Hormones, Hormone Substitutes, and Hormone Antagonists ♦ Amino Acids, Peptides, and Proteins ♦ Chemicals and Drugs ♦ Surgical Procedures, Operative ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Physical Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons
Subject Keyword Discipline Critical Care ♦ C-reactive Protein ♦ Analysis ♦ Calcitonin ♦ Blood ♦ Interleukin-6 ♦ Protein Precursors ♦ Sepsis ♦ Aged ♦ Aged, 80 And Over ♦ Analysis Of Variance ♦ Biological Markers ♦ Calcitonin Gene-related Peptide ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Postoperative Period ♦ Predictive Value Of Tests ♦ Prospective Studies ♦ Mortality ♦ Survival Analysis ♦ Time Factors ♦ Evaluation Studies ♦ Journal Article
Abstract PURPOSE: To prospectively evaluate the performance of procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) as percentage of baseline (POB) in predicting hospital survival, we studied 64 consecutive, postoperative patients with severe sepsis. MATERIALS AND METHODS: Plasma PCT, IL-6, and CRP were serially measured from day 1 (onset of sepsis) to day 14 in parallel with clinical data until day 28. Multivariate logistic regression and univariate analysis of predictive accuracy of PCT-, IL-6-, and CRP-POB were performed. Newly derived binary prediction rules were evaluated by calculating sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: In survivors, PCT and IL-6 significantly decreased from days 1 to 14, whereas CRP did not. In nonsurvivors, the inflammation markers mostly increased within the second week. At day 7, logistic regression analysis revealed PCT-POB as an independent determinant for survival. Especially, PCT-POB not exceeding 50% and PCT-POB not exceeding 25% with CRP-POB not exceeding 75% on day 7 indicated a favorable outcome with a positive predictive value/sensitivity of 75%/97% and 92%/67%, respectively. In comparison, pretest likelihood to survive by day 28 and observed survival rate were 60% and 67%, respectively. CONCLUSIONS: Prediction rules of decrease in PCT-POB on day 7 in combination with CRP-POB may serve to monitor efficacy and guide duration of therapy in critically ill patients.
Description Country affiliation: Germany
Author Affiliation: Tschaikowsky K ( Department of Anesthesiology, University of Erlangen-Nuernberg, Erlangen D-91054, Germany. klaus.tschaikowsky@rzmail.uni-erlangen.de)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2011-02-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 26
Issue Number 1


Source: WHO-Global Index Medicus