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Prognostic value of procalcitonin in children with meningococcal sepsis

Enitan D Carrol1, Paul Newland, Alistair P J Thomson

  • 1Institute of Child Health, Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK.

Critical Care Medicine
|January 13, 2005
PubMed

Insights

Procalcitonin is a superior prognostic marker for meningococcal septic shock in children. It accurately predicts septic shock, ventilation needs, and prolonged hospital stays, outperforming lactate and C-reactive protein.

Area of Science:

  • Pediatric Infectious Diseases
  • Critical Care Medicine
  • Biomarker Research

Background:

  • Meningococcal sepsis is a life-threatening condition in children.
  • Identifying reliable prognostic markers is crucial for timely intervention and improved outcomes.
  • Existing markers like lactate and C-reactive protein have limitations in predicting disease severity.

Purpose of the Study:

  • To evaluate and compare the prognostic value of procalcitonin, lactate, and C-reactive protein (CRP) in children diagnosed with meningococcal septic shock.
  • To determine which biomarker best predicts disease severity, need for mechanical ventilation, and duration of hospital stay.

Main Methods:

  • A prospective observational study was conducted.
  • The study included children admitted with meningococcal sepsis over a 16-month period.
  • Plasma levels of procalcitonin, lactate, and CRP were measured at admission.

Main Results:

  • Procalcitonin levels were significantly higher in children with septic shock, those requiring ventilation, and those with prolonged hospital stays (>10 days).
  • Procalcitonin and lactate demonstrated strong discriminatory ability for septic shock and prolonged hospital stay (AUCs 0.85-0.87).
  • Procalcitonin also effectively predicted the need for ventilation (AUC = 0.72), while CRP showed no significant discriminatory power.

Conclusions:

  • Procalcitonin serves as a reliable prognostic marker in pediatric meningococcal sepsis.
  • It demonstrates superior performance compared to lactate and C-reactive protein in predicting septic shock, ventilation requirements, and extended hospital stays.
  • These findings support the use of procalcitonin for risk stratification in children with meningococcal sepsis.
Abstract

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