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Mortality prediction model from combined serial lactate, procalcitonin and calprotectin levels in critically ill patients with sepsis: A retrospective study according to Sepsis-3 definition.
García de Guadiana-Romualdo, Luis; Botella, Lourdes Albert; Rodríguez Rojas, Carlos; Puche Candel, Angela; Jimenez Sánchez, Roberto; Conesa Zamora, Pablo; Albaladejo-Otón, María Dolores; Allegue-Gallego, José Manuel.
Afiliación
  • García de Guadiana-Romualdo L; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain. Electronic address: guadianarom@yahoo.es.
  • Botella LA; Laboratory Medicine Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
  • Rodríguez Rojas C; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain.
  • Puche Candel A; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain.
  • Jimenez Sánchez R; Critical Care Unit, Hospital Universitario Santa Lucía, Cartagena, Spain.
  • Conesa Zamora P; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain.
  • Albaladejo-Otón MD; Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain.
  • Allegue-Gallego JM; Critical Care Unit, Hospital Universitario Santa Lucía, Cartagena, Spain.
Med Intensiva (Engl Ed) ; 2024 Jun 15.
Article en En | MEDLINE | ID: mdl-38880712
ABSTRACT

OBJECTIVE:

1) To evaluate the ability of baseline and on 24 h serum calprotectin, in comparison to canonical biomarkers (lactate and procalcitonin), for prognosis of 28-day mortality in critically ill septic patients; and 2) To develop a predictive model combining the three biomarkers.

DESIGN:

A single-center, retrospective study.

SETTING:

Intensive Care Unit of a university hospital. PATIENTS OR

PARTICIPANTS:

One hundred and seventy three septic pacientes were included.

INTERVENTIONS:

Measurement of baseline lactate, procalcitonin and calprotectin level and procalcitonin and calprotectin levels on 24 h. MAIN VARIABLES OF INTEREST Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality.

RESULTS:

1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC 0.766), trending to increase (AUC 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome.

CONCLUSIONS:

1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Med Intensiva (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Med Intensiva (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España