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Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric
Insights
Procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) show prognostic value in pediatric sepsis. Combining these biomarkers improves risk stratification for better patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Sepsis poses a significant threat to children, necessitating accurate prognostic tools.
- Existing biomarkers may have limitations in predicting outcomes for pediatric sepsis.
Purpose of the Study:
- To evaluate the prognostic significance of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in pediatric sepsis.
- To assess the combined diagnostic and prognostic value of these biomarkers.
Main Methods:
- A cohort of 214 children hospitalized with sepsis was studied.
- Serum levels of PCT, hs-CRP, and PSP were measured on admission.
- Correlation with Pediatric Critical Illness Score (PCIS) and 28-day survival rates were analyzed using logistic regression and ROC analysis.
Main Results:
- Higher PCT, hs-CRP, and PSP levels were observed in non-surviving patients (p<0.001).
- These biomarkers were negatively correlated with PCIS (p<0.001) and identified as independent risk factors.
- Individual AUC values ranged from 0.73 to 0.83; the combined AUC reached 0.92, significantly outperforming individual markers (p<0.001).
Conclusions:
- Serum PCT, hs-CRP, and PSP are valuable prognostic biomarkers in pediatric sepsis.
- Their combination offers a powerful tool for clinical risk stratification and improved patient management.
Abstract:
BACKGROUND To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis. MATERIAL AND METHODS A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson's correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients' death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis. RESULTS The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson's correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77-0.88), 0.76 (95% CI, 0.70-0.82), and 0.73 (95% CI, 0.67-0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87-0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001). CONCLUSIONS The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.