The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients: A multicenter prospective registry-based observational study

Sci Rep. 2019 Apr 29;9(1):6579. doi: 10.1038/s41598-019-42972-7.

Abstract

The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7%. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95% Confidence intervals 1.184-2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.

Publication types

  • Multicenter Study

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Calcitonin Gene-Related Peptide / blood
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Procalcitonin / blood*
  • Prognosis
  • Registries
  • Sepsis / blood*
  • Sepsis / mortality
  • Sepsis / pathology
  • Shock, Septic / blood*
  • Shock, Septic / mortality
  • Shock, Septic / pathology

Substances

  • Biomarkers
  • Procalcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide