Introduction
There is much evidence to suggest that increased, early induction of PCT following
varying incidents is suggestive of subsequent potential complications. This applies
to the postoperative period and multiple trauma, as well as other diseases.
Aim of the study
In our study, the purpose was to examine the PCT fluctuation in relation to the early
signs of infection, to find out whether PCT indicates a significant predictive value
of infection.
Materials and methods
Between 1 January 2001 and 31 December 2001, 248 patients were studied (among the
347 patients who were admitted in our general ICU). Finally, 125 patients were stratified
in our study. The rest of the patients were excluded because the length stay in ICU
was limited (< 5 days). All patients were divided into four groups according to the
reason for admission.
Group A
56 multiple trauma (43 men, 13 women, mean age 49.2 years, mean ICU stay 13.4 days,
APACHE II score 17–22).
Group B
19 postoperative (10 men, nine women, mean age 49.5 years, mean ICU stay 11.7 days,
APACHE II score 20–24).
Group C
19 pathologic (12 men, seven women, mean age 50.7 years, mean ICU stay 14.8 days,
APACHE II score 22–25).
Group D
31 cerebral stroke (18 men, 13 women, mean age 49.5 years, mean ICU stay 14.2 days,
APACHE II score 18–23). Each group was divided in two subgroups: (I) patients possessing
early (days 0–2) signs of infection (elevated WBC, CRP, temperature/reduced platelets,
fibrinogen/positive cultures); (II) patients free of early signs of infection.
Results
In group A, 32 patients had positive signs of infection, but PCT had no parallel fluctuation
with the other markers of inflammation, whereas mortality (30%) was related to high
PCT levels (> 2 ng/ dl). In group B, seven patients had positive signs of infection,
mortality was 31% and similar results with group A were noted. In group C, nine patients
had positive signs of infection and mortality was 47%, while PCT levels indicated
promptly the fatal outcome. Finally, in group D, only 14 patients had positive signs
of infection, mortality was 32% and PCT levels were slightly higher in those who did
not survive.
Conclusion
Numerous triggers can induce PCT and it has no significant predictive value as the
only marker of inflammation. In our study, mortality was directly related to high
PCT levels (> 2 ng/dl), while values more than 30 ng/dl were absolutely related to
fatal outcome.