(1556) Identifying Sepsis Patients at High Risk of Mortality Using Procalcitonin Trajectory

Sunday, February 23, 2025

9:45am – 10:45am Eastern Time

Location: Connections Central - RST 08

First Author(s)

XW

Xu Wang, N/A

Dr.
Department of Critical Care Medicine, Zhongshan Hospital of Fudan University, Shanghai, China, United States

Co-Author(s)

YF

Yao Fu, N/A

Dr.
Department of Critical Care Medicine, Shanghai Geriatric Medical Center, Shanghai, China, United States
SL

Shilong Lin, N/A

Dr.
Department of Critical Care Medicine, Zhongshan Hospital of Fudan University, Shanghai, China., United States
ZH

Zhenhua He, N/A

Dr.
Department of Critical Care Medicine, The People's Hospital of Dehong, Kunming Medical University, Yunnan, China, United States
Hongyu He, N/A (she/her/hers)

Shanghai, Shanghai, CHN
YAO YAO, n/a (she/her/hers)

China (People's Republic)
YZ

Yunhang Zhang, N/A

Dr.
Department of Critical Care Medicine, Zhongshan Hospital of Fudan University, Shanghai, China., United States
MZ

Ming Zhong, n/a

Professor
Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, China (People's Republic)
JS

Jieqiong Song, n/a

Professor
Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, United States

Introduction: Procalcitonin (PCT) has been recommended as a valuable biomarker in the management of sepsis due to its sensitivity to bacterial infections. However, the relation between PCT trajectory and mortality remains unclear. This study aims to investigate the trajectory of PCT levels in sepsis patients and its correlation with survival outcomes.

Methods: We retrospectively reviewed patients who were diagnosed with sepsis from Jan 2019 to March 2024 at Zhongshan Hospital Fudan University. PCT measurements within the first 7-day in ICU were included and hierarchical linear mixed-effects (HLME) model was constructed to identify latent classes of PCT trajectory. Baseline characteristics across these classes were compared. Proportional hazard model was performed to study the association between PCT trajectory classes and survival probability.

Results: In total, 564 patients diagnosed with sepsis (174/31% female; median age 68.5 years [IQR: 59-77] were included. Three classes were identified regarding PCT trajectory: “high-value-slow-decrease” class (Class 1, n=43/8%), “low-value-slow-decrease” class (Class 2, n=354/66%), “high-value-fast-decrease” class (Class 3, n=140/26%). The baseline Sequential Organ Failure Assessment (SOFA) score and lactate, septic shock proportion, and in-hospital mortality were the highest in Class 1. PCT trajectory in Class 1 is an independent risk factor for in-hospital mortality compared to Class 2 (HR 0.507[95% CI, 0.287-0.895], P=0.020) and Class 3 (HR 0.449 [95% CI, 0.244, 0.827], P=0.011) .

Conclusions: PCT trajectory can be utilized to distinguish different clinical outcomes in sepsis patients. Patients exhibiting “high-value-slow-decrease” PCT trajectory are at a relatively higher risk of in-hospital mortality.