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J Korean Soc Emerg Med > Volume 34(3); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(3): 249-255.
패혈증 환자에서 패혈쇼크의 발생을 예측하기 위한 프로칼시토닌의 효용성
임형빈 , 권효정 , 김보람 , 김상민 , 홍석인 , 채보라 , 김원영 , 유승목
울산대학교 의과대학 서울아산병원 응급의학과
The predictive value of procalcitonin for septic shock in sepsis patients
Hyoung Bin Lim , Hyo Jeong Kwon , Boram Kim , Sang-Min Kim , Seok-in Hong , Bora Chae , Won Young Kim , Seung Mok Ryoo
Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence  Seung Mok Ryoo ,Tel: 02-3010-5326, Fax: 02-3010-3360, Email: chrisryoo@gmail.com,
Received: July 29, 2022; Revised: September 16, 2022   Accepted: September 16, 2022.  Published online: June 30, 2023.
This study examined the difference in procalcitonin between sepsis and septic shock.
The single-center retrospective cohort study was conducted from July 2017 to June 2018 at an emergency department (ED) of a university hospital. The inclusion criteria were patients over 18 years old who visited the ED with an infection. The exclusion criteria were the patients without organ failure by sepsis-3 definition, those with missing serum lactate data, and those discharged without workup. The sepsis patients were divided into those with and without septic shock, and the two groups were compared with biomarkers, including procalcitonin.
Of the 406 patients who visited the ED with an infection, 36 were excluded because they did not have sepsis or an unknown infection. Finally, 369 patients were enrolled, and 61.5% fitted the septic shock definition. A comparison of the septic shock and non-shock sepsis groups showed that a history of chronic liver disease, malignancy, pulse rate, prothrombin time, blood urea nitrogen, aspartate and alanine transaminase, troponin-I, Sequential Organ Failure Assessment score and procalcitonin levels were significantly higher in the septic shock group. In multivariate analysis, however, procalcitonin was an independent predictor for septic shock (adjusted odd ratio, 1.05; 95% confidential interval, 1.01-1.09). The area under the receiver operating characteristic curve was 0.729, and the cutoff value was 4.0 ng/mL.
The procalcitonin levels were higher in the septic shock group than in the non-shock sepsis group. This could help predict septic shock independently. Further prospective multicenter research is needed to determine if procalcitonin can predict the severity of sepsis.
Key words: Septic shock; Procalcitonin; Sepsis
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