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[Value of Procalcitonin, High Sensitivity C-reactive Protein and Pancreatic Stone Protein in Predicting Prognosis of
Jun-Ming Huo1, Rui Huo2, Ling Hu3
1Department of ICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China.
Insights
Procalcitonin (PCT), hs-CRP, and PSP effectively predict prognosis in pediatric sepsis. Combining these biomarkers offers a powerful tool for assessing survival outcomes in critically ill children.
Area of Science:
- Biomarker discovery and validation in pediatric critical care.
- Sepsis diagnostics and prognostics in pediatric populations.
- Clinical utility of inflammatory markers in severe infections.
Background:
- Pediatric sepsis is a life-threatening condition requiring accurate prognostic tools.
- Early identification of high-risk children is crucial for timely intervention.
- Existing prognostic markers may lack sufficient accuracy or specificity.
Purpose of the Study:
- To evaluate procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) for predicting prognosis in pediatric sepsis.
- To assess the combined predictive value of these biomarkers.
- To identify a threshold for good prognosis based on combined marker levels.
Main Methods:
- Serum levels of PCT, hs-CRP, and PSP were measured in 106 hospitalized children with sepsis.
- Correlations with the Pediatric Critical Illness Score (PCIS) were analyzed.
- Logistic regression and ROC curve analyses determined predictive accuracy for mortality and prognosis.
Main Results:
- Higher PCT, hs-CRP, and PSP levels were significantly associated with mortality (P<0.001).
- These markers were independent predictors of death and negatively correlated with PCIS.
- A combined model (0.481×PCT+0.392×hs-CRP+0.314×PSP) achieved an AUC of 0.92, with a threshold of 122.3 indicating good 28-day prognosis.
Conclusions:
- Serum PCT, hs-CRP, and PSP are valuable predictors of prognosis in children with sepsis.
- The combined assessment of these biomarkers significantly enhances prognostic accuracy.
- This multi-biomarker approach can aid in clinical decision-making for pediatric sepsis management.
Objectives:
To determine the value of procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP) and pancreatic stone protein(PSP) in predicting the prognosis of children with sepsis.
Methods:
A total of 106 hospitalized children [(4.4±1.6) year-old] with sepsis were enrolled in this study. The expressions of PTC, hs-CRP and PSP in the serum samples of the children were detected on the first day of admission to hospital. Pearson correlation analyses were performed to test the correlations between pediatric critical illness score (PCIS) and PTC, hs-CRP and PSP. Logistic regression models were established to determine factors predicting death of children. The value of PTC, hs-CRP and PSP in predicting the prognosis of children with sepsis was determined using ROC curves.
Results:
About 32% children (34 cases) died. Higher expressions of PTC, hs-CRP and PSP were found in those who died (P<0.001). Serum PTC, hs-CRP and PSP were negatively correlated with PCIS (P<0.001). The multivariate logistic regression showed that PTC, hs-CRP and PSP were independent predictors of death in patients with sepsis (P<0.001). PTC, hs-CRP and PSP had an area under the curve (AUC) value of 0.86[ (95% confidence interval (CI), 0.78-0.92], 0.70 (95%CI, 0.61-0.79) and 0.69 (95%CI, 0.60-0.78) , respectively.The AUC value increased (P<0.001) to 0.92 (95%CI, 0.85-0.96) when the three indicators were combined (0.481×PCT+0.392×hs-CRP +0.314*PSP), with a value of less than 122.3 indicating good prognosis in 28 d.
Conclusions:
Serum PTC, hs-CRP and PSP can predict prognosis of children with sepsis.
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