Diagnostic Value Of Procalcitonin For Early Infection Of Post-resuscitation Syndrome With Sudden Death Outside The Hospital And Its Relationship With Prognosis

Objective: To explore the diagnostic value of procalcitonin for early infection in patients with sudden death outside the hospital and relationship with prognosis,and to provide reference for the diagnosis and treatment of infection in these patients.Methods: Retrospective analysis of January 1st,2015 to October 31 st,2018sudden death outside the hospital with survival ? 7 days and age?15,asmitted to the ICU at the First Affiliated Hospital of Guangxi Medical University,a total of32 cases were met in the inclusion criteria.Refer to the Utstein model to collect patient baseline data ? infection characteristics(infection site ? degree and pathogenic culture results)?procalcitonin and C-reactive protein and white blood cell concentration on the day of within 24h?48h?72h and 7th day.Using t test or Mann-Whitney U test or Fisher exact probability method to analyze the difference between observation index and post-resuscitation syndrome patients were whether the occurrence of nosocomial infection within 1 week and within28 days mortality rate;logistic regression analysis of the correlation between each indicator and mortality within 28-days death.Results: 1.32 patients were included in the study in total,the average time of hospital stay was(23.03±21.492)day,and 26 cases(81.25%,including 23 patients with pulmonary infection)were infected.10/32(31.25%)of patients with nosocomial infection occurred within 1 week,and the highest infection rate was lower respiratory tract infection(9 cases,90.00%),among which 8 cases(80.00%)were positive in alveolar lavage pathogen culture.The comparison of the nosocomial infection group and the non-infected group,the PCT?CRP level of the infection group was higher than that of the non-infection group on the 7th day,which was statistically significant(P<0.05);the ROC curve shows that the area under the PCT and CRP curves on the 7th day was 0.755 and 0.720,respectively.2.In this study,the 28-day mortality rate was 15/32(46.88%).The results of the twe groups sowed that the death group APACHE II score and SOFA score and PCT concentration on the day of 48h?72h were higher the survival group,and the GCS score was lower the survival group(P<0.05),which were significant differences.Logistic multivariate regression analysis shows that APACHE II score and GCS score were independent factors predicting prognosis(P=0.041,OR=1.641,95%CI:1.021-2.637;P=0.049,OR=0.678,95%CI:0.460-0.999).Conclusion: Serum PCT and CRP concentrations on day 7 was significant correlation with the infection within 1 week of patients with post cardiac attest syndrome.Serum PCT concentration,SOFA score were not correlated with death within 28 days,but APACHE II score and GCS score are independent factors predicting death within 28 days.