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Published on: March 26, 2019
Elevated PCT at ICU discharge predicts poor prognosis in patients with severe traumatic brain injury: a retrospective
Yu-Rong Wang1, Qing-Bin Zheng1, Guang-Fa Wei1
1Department of Critical Care Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China.
Insights
Elevated serum procalcitonin (PCT) levels in severe traumatic brain injury (STBI) patients upon intensive care unit (ICU) discharge indicate a higher risk of poor prognosis. However, PCT alone has limited clinical predictive value.
Area of Science:
- Critical Care Medicine
- Neurology
- Biomarkers
Background:
- Prognostic assessment in severe traumatic brain injury (STBI) is crucial for patient outcomes.
- Inflammatory markers are key indicators of prognosis in STBI patients.
- The predictive role of serum procalcitonin (PCT) for prognosis in STBI patients before intensive care unit (ICU) discharge requires clarification.
Purpose of the Study:
- To investigate the association between elevated serum PCT levels at ICU discharge and poor prognosis in STBI patients.
- To determine if serum PCT can serve as a predictive marker for adverse outcomes in STBI survivors.
Main Methods:
- Retrospective observational cohort study of 199 STBI patients.
- Patients were stratified into high-PCT (≥0.25 ng/mL) and low-PCT (<0.25 ng/mL) groups based on discharge serum PCT levels.
- Multivariate logistic regression analyzed the relationship between PCT and adverse outcomes, controlling for other clinical factors.
Main Results:
- Patients in the high-PCT group exhibited a significantly higher rate of adverse outcomes compared to the low-PCT group.
- Discharge serum PCT levels were independently associated with adverse outcomes in STBI patients.
- APACHE II score, SOFA score, WBC count, and CRP level also correlated significantly with poor prognosis.
Conclusions:
- Elevated serum PCT levels at ICU discharge are linked to a poor prognosis in STBI patients.
- Serum PCT may serve as a valuable prognostic indicator in STBI, but its utility as a sole clinical decision-making tool is limited.
- Further research may explore combining PCT with other biomarkers for enhanced prognostic accuracy.
Purpose:
Disease severity and inflammatory response status are closely related to a poor prognosis and must be assessed in patients with severe traumatic brain injury (STBI) before intensive care unit (ICU) discharge. Whether elevated serum procalcitonin (PCT) levels can predict a poor prognosis in STBI patients before ICU discharge is unclear.
Methods:
This retrospective observational cohort study enrolled 199 STBI patients who were in the ICU for at least 48 hours and survived after discharge. Based on serum PCT levels at discharge, patients were divided into the high-PCT group (PCT ≥ 0.25 ng/mL) and the low-PCT group (PCT < 0.25 ng/mL). We assessed the relationship between serum PCT levels and a poor prognosis.
Results:
The high-PCT group had a higher rate of adverse outcomes compared with the low-PCT group. Multivariate logistic regression analysis showed that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, white blood cell (WBC) count, C-reactive protein (CRP) level, and PCT level at discharge were significantly associated with adverse outcomes.
Conclusions:
Elevated PCT levels at ICU discharge were associated with a poor prognosis in STBI patients. The serum PCT level as a single indicator has limited value for clinical decision-making.
