Predictive Value of Procalcitonin in Children with Suspected Sepsis
Keywords:
Procalcitonin, Sepsis, PediatricsAbstract
Background: Septic shock is a major cause of mortality in pediatrics, with an estimated 4,000 children dying annually in the U.S. Early antibiotic treatment combined with an appropriate hemodynamic strategy has the greatest impact on prognosis.
Objective: To assess the predictive value of procalcitonin in children with suspected sepsis.
Patients and method: Prospective observational study approved by the Ethics Committee of the our Hospital. Informed consent was not required. All patients with suspected sepsis admitted to the Pediatric ICU between September 2021 and April 2023 who had not received systemic antibiotics for more than 24 hours were included.
Results: Eighty-one patients were included, 11 (13.5%) died in the ICU. The origin of sepsis was respiratory in 36 (44%) cases, onco-hematological in 12 (15%) and central nervous system in 9 (11%) cases. AUC they revealed a favorable discriminatory power of PCT and lactate of 80% with significant differences (p<0.001) for Procalcitonin and 76% (95% CI: 0.65-0.85) (p=0.003) for lactate, respectively, in predicting ICU mortality. PCT values>33ng/mL had a sensitivity of 73% and a specificity of 86% in predicting ICU mortality with a positive LR of 5 and a negative predictive value of 95.2%. In the logistic regression analysis, only PCT was relevant in predicting ICU mortality, with an OR (95%CI) of 11 (2.4-51) (p=0.02).
Conclusion: Assessing Procalcitonin in pediatric patients with suspected sepsis upon ICU admission serves as an effective predictor of mortality and septic shock, enabling stratification according on the severity of sepsis.
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