The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients

A multicenter prospective registry-based observational study

Korean Shock Society (KoSS) Investigators

Research output: Contribution to journalArticle

Abstract

The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7%. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95% Confidence intervals 1.184–2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.

Original languageEnglish
Article number6579
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

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Calcitonin
Septic Shock
C-Reactive Protein
Observational Studies
Registries
Mortality
Multivariate Analysis
Biomarkers
Odds Ratio
Prospective Studies
Confidence Intervals

ASJC Scopus subject areas

  • General

Cite this

The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients : A multicenter prospective registry-based observational study. / Korean Shock Society (KoSS) Investigators.

In: Scientific Reports, Vol. 9, No. 1, 6579, 01.12.2019.

Research output: Contribution to journalArticle

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title = "The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients: A multicenter prospective registry-based observational study",
abstract = "The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7{\%}. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95{\%} Confidence intervals 1.184–2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.",
author = "{Korean Shock Society (KoSS) Investigators} and Ryoo, {Seung Mok} and Han, {Kap Su} and Shin Ahn and Shin, {Tae Gun} and Hwang, {Sung Yeon} and Chung, {Sung Phil} and Hwang, {Yoon Jung} and Park, {Yoo Seok} and Jo, {You Hwan} and Chang, {Hyung Lan} and Suh, {Gil Joon} and You, {Kyoung Min} and Kang, {Gu Hyun} and Choi, {Sung Hyuk} and Lim, {Tae Ho} and Kim, {Won Young} and Kim, {Youn Jung} and Lee, {Sung Woo} and Jo, {Ik Joon} and Kim, {Min Joung} and Kwon, {Woon Yong} and Lee, {Hui Jai} and Shin, {Jong Hwan} and Ko, {Byuk Sung}",
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T1 - The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients

T2 - A multicenter prospective registry-based observational study

AU - Korean Shock Society (KoSS) Investigators

AU - Ryoo, Seung Mok

AU - Han, Kap Su

AU - Ahn, Shin

AU - Shin, Tae Gun

AU - Hwang, Sung Yeon

AU - Chung, Sung Phil

AU - Hwang, Yoon Jung

AU - Park, Yoo Seok

AU - Jo, You Hwan

AU - Chang, Hyung Lan

AU - Suh, Gil Joon

AU - You, Kyoung Min

AU - Kang, Gu Hyun

AU - Choi, Sung Hyuk

AU - Lim, Tae Ho

AU - Kim, Won Young

AU - Kim, Youn Jung

AU - Lee, Sung Woo

AU - Jo, Ik Joon

AU - Kim, Min Joung

AU - Kwon, Woon Yong

AU - Lee, Hui Jai

AU - Shin, Jong Hwan

AU - Ko, Byuk Sung

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N2 - The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7%. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95% Confidence intervals 1.184–2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.

AB - The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7%. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95% Confidence intervals 1.184–2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.

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