Procalcitonin concentrations as a predictor of unexpected readmission and mortality after intensive care unit discharge: A retrospective cohort study

Zhou, G. and Ho, K.M. (2016) Procalcitonin concentrations as a predictor of unexpected readmission and mortality after intensive care unit discharge: A retrospective cohort study. Journal of Critical Care, 33 . pp. 240-244.

Abstract

Procalcitonin (PCT) has been used to guide treatment in critically ill patients with sepsis, but whether PCT at intensive care unit (ICU) discharge can stratify risks of post-ICU readmission or mortality is unknown. This cohort study compared the ability of PCT to C-reactive protein (CRP) in predicting unexpected adverse post-ICU events. Of the 1877 patients admitted to the multidisciplinary ICU between 1 April 2012 and 31 March 2014, 1653 (88.1%) were discharged without treatment limitations. A total of 71 (4.3%) were readmitted and 18 patients (1%) died unexpectedly after ICU discharge during the same hospitalization. Both PCT (0.6 vs. 0.4ug/L, p=0.002) and a high CRP concentration > 100mg/L (58% vs. 41%, p=0.004) at ICU discharge were associated with an increased risk of adverse post-ICU events in the univariate analyses, however the ability of PCT to discriminate between patients with and without adverse post-ICU outcomes was limited (area under the receiver-operating-characteristic curve = 0.61, 95% confidence interval [CI]: 0.55-0.66). In the multivariable analysis, only a high CRP concentration (odds ratio 1.92, 95%CI: 1.12-3.11; p=0.008) was associated with an increased adverse post-ICU events. Elevated PCT concentration at ICU discharge was inadequate in its predictive ability to guide ICU discharge.

Item Type:	Journal Article
Murdoch Affiliation(s):	School of Veterinary and Life Sciences
Publisher:	Elsevier B.V.
Copyright:	© 2016 Elsevier B.V.
URI:	http://researchrepository.murdoch.edu.au/id/eprint/30382

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