Procalcitonin as a prognostic marker for outcomes in post-cardiac arrest patients: A systematic review and meta-analysis

Area of Science:

• Critical Care Medicine
• Biomarkers
• Prognostic Studies

Background:

• Post-cardiac arrest syndrome (PCAS) is a complex clinical condition with significant mortality and morbidity.
• Identifying reliable prognostic biomarkers is crucial for guiding patient management and treatment strategies.

Purpose of the Study:

• To evaluate the utility of procalcitonin as a prognostic biomarker for outcomes in patients following cardiac arrest.
• To synthesize existing evidence on the association between procalcitonin levels and patient outcomes after cardiac arrest.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and Cochrane Library up to January 8, 2019.
• Inclusion of studies measuring procalcitonin levels in patients with return of spontaneous circulation after out-of-hospital cardiac arrest.
• Quality assessment using the Quality in Prognosis Studies tool and subgroup analyses for confounding factors.

Main Results:

• Ten studies involving 1065 patients were included.
• Elevated procalcitonin levels (0-24h) were linked to increased in-hospital mortality (SMD 0.64, 95% CI 0.33-0.95).
• Elevated procalcitonin levels (0-48h) correlated with poor neurological outcomes at various time points (0-24h, 24-48h, and 1-6 months).

Conclusions:

• Elevated procalcitonin levels within 0-48 hours post-cardiac arrest are associated with adverse patient outcomes.
• Procalcitonin shows potential as a prognostic biomarker in the management of post-cardiac arrest patients.
• Further research may refine the role of procalcitonin in predicting outcomes in this critical patient population.