Serum Procalcitonin Level And SOFA Score At Discharge From The Intensive Care Unit Predict Post-intensive Care Unit Mortality

Objective: With the continuous development of intensive care at present, more and more serious patients are treated, it makes the patient’s quality of life improved, but even patients with critically ill get successful treatment in ICU until discharge, some patients may have sequela, including cognitive dysfunction, physical function(post-intensive syndrome) or poor effect. Perhaps institution and regional characteristics will affect the ICU discharge criteria,critically ill patients are generally considered suitable and need for discharge from ICU when patients physiological state has standard and the need for ICU monitoring and care is no longer necessary. The decision for discharge is uncertain, is largely determined by the patient factors. However, we should set an objective evaluation.Previous studies have conflicting or unreliable. We analyze physical and laboratory data to predict ICU mortality after discharge from ICU.Methods: We selected patients from September 1, 2013 to August 31, 2014 in Harrison International Peace Hospital Intensive Care Unit, in hospital time more than 2 days.We recorded the patient gender, age, and the reason for admission to ICU, length of hospital stay, whether mechanical ventilation, whether application of vascular active drugs, Sequential Organ Failure Assessment(SOFA) score,white blood cell count(WBC), serum c-reactive protein(CRP), procalcitonin(PCT) and lactic acid(Lac), albumin(Alb) and hemoglobin(Hb) level. The main study endpoint is the 90 th day mortality after discharge from ICU. Follow-up to discharge after 90 days, we compared the similarities and differences between survival group and death group.Results: There are 377 patients admission to ICU, 37 patients(9.8%) abandoned treatment,33 patients(8.6%)died.307 patients(81.6%)survived to discharge from ICU. The length of 298 patients in ICU is longer than 2 days.30 patients were lost to follow-up, 12 patients were readmission to ICU, including 5 retired veterans. We only recorded the data of 256 patients, 7 patients for age factors were excluded.249 patients were included in the study. 1 Generally condition of selected patientsSource: patients with trauma 19 cases, infection in 62 cases, 20 cases of heart failure, renal failure 11 cases, cardiopulmonary resuscitation(CPR) 11 cases, chronic obstructive pulmonary disease 43 cases, the central nervous system disease 39 cases, pregnancy associated disease 14 cases, surgical 30 cases. Survival group, a total of 221 cases, 127 men(57.5%), 94 women(42.5%), death group, a total of 28 cases, 20(71.4%) cases of male, female 8 cases(28.6%). The average age of survival group is 67, The average age of death group is 65. The average time of survival patients in ICU is 17.7 days, mechanical ventilation cases is 128 cases(57.9%), 31(14.0%) cases of application of vasoactive drugs; The average time of death patients in ICU is 18.1 days, 18 cases(64.3%) cases of mechanical ventilation, 5(17.9%) cases using vascular active drug.Comparing the two groups have no statistical difference(P>0.05). 2 Laboratory examination indexsDeath group compared with survival group, PCT and SOFA score are higher than the survival group, albumin and hemoglobin level are lower than the survival group, the difference is statistically significant(P<0.05), leukocyte count, CRP and lactic acid are higher than survival group, but have no statistical difference(P>0.05).Conclusion: Death group patients have higher levels of SOFA score and PCT, serum albumin and hemoglobin are lower than the survival group.PCT, serum albumin and SOFA score related to patients the 90- day mortality. High PCT, low protein and high SOFA group have higher mortality rates.PCT and SOFA score are related to the days after discharge from the ICU.Serum PCT and SOFA score can predict mortality, and survival days after the discharge from ICU. And the federation of albumin levels, it makes the prediction more accurate.