Prognosis Factors Analysis In Septic Patients With High Levels Of Serum Procalcitonin

Objective:To identify prognosis factors analysis of septic patients with high levels serum procalcitonin(PCT>100ug/L).Method:We collected the clinical data of septic patients with high of serum PCT(>100?g/L)within 48 hours of admission in the Second Hospital Affiliated to Zhejiang University Medical College from October 2014 to October 2017,including of general information,vital signs,24 hours' urine volume,blood routine,biochemical complete set,coagulation spectrum,myocardial enzymes,arterial blood gas analysis,admission department,main diagnosis of admission,complications,APACHE ? and SOFA scores,the presence of shock and the need for ventilator treatment in the day of serum PCT>100?g/L.The collected data were divided into survival group and death group according to 28-day outcome.Univariate analysis was used for comparison between groups,and the death risk factors were analyzed with multi-factorial logistic regression analysis.Rusults:171 cases of such septic patients were include.They were 118 males(69.0%),with an average age of 62(50,76)years.Most patients distributed in intensive care unit(ICU,67.8%,116/171).The patients were mostly complicated with multiple organ dysfunction syndrome(MODS,57.9%),after chest and abdominal surgery(20.5%),trauma/bum(9.4%)and post-cardiopulmonary resuscitation(post-CPR,5.8%).The mortality rate was 37.4%(64/171).Compared with the survival group,MODS(89.1%vs.39.4%),trauma/burn(28.8%vs.3.7%),post-CPR(12.5%vs.1.9%),and primary diagnosis overlay number(2.0(2.0,3.0)vs.2.0(1.0,2.0)),ventilator support(79.7%vs 39.3%)and the proportion of shock(100.0%vs 59.8%),and acute physiology and chronic health evaluation system ?(APACHE ?:24(18,28)vs.14(10,16),the sequential organ failure score(SOFA:16(12,18)vs.9(6,12))were significantly elevated,liver function,coagulation indexes,myocardial enzymes and lactic acid level(Lac)were also higher than those in survivors(all p<0.05).While the platelet count(PLT)was significantly lower than that in survivors.Multi-factorial logistic regression analysis showed that a high score of APACHE ? score[(odds ratio(OR)=1.389,95%confidence interval(95%CI)=1.162?1.661,p=0.000]and MODS(OR=36.481,95%CI=3.503?379.960,p=0.003)on admission were associated with poor prognosis.Conclusions:The majority of septic patients with high level of serum PCT(>100?g/L)was complicated with MODS,especially respiratory and circulatory dysfunction,.Some laboratory parameters including PLT,lactic acid,liver function,coagulation indexes and cardiac enzymes were correlated with a poor prognosis of these septic patients.High APACHE ? score and the incidence of MODS were independent predictors of poor prognosis in these septic patients with high level of serum PCT.