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Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis

Background: The management of septic patients hospitalized in Internal Medicine wards represents a challenge due to their complexity and heterogeneity, and a high mortality rate. Among the available prognostic tools, procalcitonin (PCT) is considered a marker of bacterial infection. Furthermore, an...

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Autores principales: Tosoni, Alberto, Cossari, Anthony, Paratore, Mattia, Impagnatiello, Michele, Passaro, Giovanna, Vallone, Carla Vincenza, Zaccone, Vincenzo, Gasbarrini, Antonio, Addolorato, Giovanni, De Cosmo, Salvatore, Mirijello, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066199/
https://www.ncbi.nlm.nih.gov/pubmed/33915819
http://dx.doi.org/10.3390/medicina57040331
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author Tosoni, Alberto
Cossari, Anthony
Paratore, Mattia
Impagnatiello, Michele
Passaro, Giovanna
Vallone, Carla Vincenza
Zaccone, Vincenzo
Gasbarrini, Antonio
Addolorato, Giovanni
De Cosmo, Salvatore
Mirijello, Antonio
author_facet Tosoni, Alberto
Cossari, Anthony
Paratore, Mattia
Impagnatiello, Michele
Passaro, Giovanna
Vallone, Carla Vincenza
Zaccone, Vincenzo
Gasbarrini, Antonio
Addolorato, Giovanni
De Cosmo, Salvatore
Mirijello, Antonio
author_sort Tosoni, Alberto
collection PubMed
description Background: The management of septic patients hospitalized in Internal Medicine wards represents a challenge due to their complexity and heterogeneity, and a high mortality rate. Among the available prognostic tools, procalcitonin (PCT) is considered a marker of bacterial infection. Furthermore, an association between vitamin D deficiency and poor sepsis-related outcomes has been described. Objectives: To evaluate the prognostic accuracy of two consecutive PCT determinations (Delta-PCT) and of vitamin D levels in predicting mortality in a population of patients with microbiological identified sepsis admitted to Internal Medicine wards. Methods: This is a sub-analysis of a previous prospective study. A total of 80 patients had at least two available consecutive PCT determinations, while 63 had also vitamin D. Delta-PCT was defined as a reduction of PCT > 50% after 48 h, >75% after 72 h, and >85% after 96 h. Mortality rate at 28- and 90-days were considered as main outcome. Results: Mortality rate was 18.7% at 28-days and 30.0% at 90-days. Baseline PCT levels did not differ between survived and deceased patients (28-days: p = 0.525; 90-days: p = 0.088). A significantly higher proportion of survived patients showed Delta-PCT (28-days: p = 0.002; 90-days: p < 0.001). Delta-PCT was associated with a lower 28-days (p = 0.007; OR = 0.12, 95%CI 0.02–0.46) and 90-days mortality (p = 0.001; OR = 0.17, 95%CI 0.06–0.48). A significantly higher proportion of deceased patients showed severe vitamin D deficiency (28-days: p = 0.047; 90-days: p = 0.049). Severe vitamin D deficiency was associated with a higher 28-days (p = 0.058; OR = 3.95, 95%CI 1.04–19.43) and 90-days mortality (p = 0.054; OR = 2.94, 95%CI 1.00–9.23). Conclusions: Delta-PCT and vitamin D represent two useful tests for predicting prognosis of septic patients admitted to Internal Medicine wards.
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spelling pubmed-80661992021-04-25 Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis Tosoni, Alberto Cossari, Anthony Paratore, Mattia Impagnatiello, Michele Passaro, Giovanna Vallone, Carla Vincenza Zaccone, Vincenzo Gasbarrini, Antonio Addolorato, Giovanni De Cosmo, Salvatore Mirijello, Antonio Medicina (Kaunas) Article Background: The management of septic patients hospitalized in Internal Medicine wards represents a challenge due to their complexity and heterogeneity, and a high mortality rate. Among the available prognostic tools, procalcitonin (PCT) is considered a marker of bacterial infection. Furthermore, an association between vitamin D deficiency and poor sepsis-related outcomes has been described. Objectives: To evaluate the prognostic accuracy of two consecutive PCT determinations (Delta-PCT) and of vitamin D levels in predicting mortality in a population of patients with microbiological identified sepsis admitted to Internal Medicine wards. Methods: This is a sub-analysis of a previous prospective study. A total of 80 patients had at least two available consecutive PCT determinations, while 63 had also vitamin D. Delta-PCT was defined as a reduction of PCT > 50% after 48 h, >75% after 72 h, and >85% after 96 h. Mortality rate at 28- and 90-days were considered as main outcome. Results: Mortality rate was 18.7% at 28-days and 30.0% at 90-days. Baseline PCT levels did not differ between survived and deceased patients (28-days: p = 0.525; 90-days: p = 0.088). A significantly higher proportion of survived patients showed Delta-PCT (28-days: p = 0.002; 90-days: p < 0.001). Delta-PCT was associated with a lower 28-days (p = 0.007; OR = 0.12, 95%CI 0.02–0.46) and 90-days mortality (p = 0.001; OR = 0.17, 95%CI 0.06–0.48). A significantly higher proportion of deceased patients showed severe vitamin D deficiency (28-days: p = 0.047; 90-days: p = 0.049). Severe vitamin D deficiency was associated with a higher 28-days (p = 0.058; OR = 3.95, 95%CI 1.04–19.43) and 90-days mortality (p = 0.054; OR = 2.94, 95%CI 1.00–9.23). Conclusions: Delta-PCT and vitamin D represent two useful tests for predicting prognosis of septic patients admitted to Internal Medicine wards. MDPI 2021-04-01 /pmc/articles/PMC8066199/ /pubmed/33915819 http://dx.doi.org/10.3390/medicina57040331 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tosoni, Alberto
Cossari, Anthony
Paratore, Mattia
Impagnatiello, Michele
Passaro, Giovanna
Vallone, Carla Vincenza
Zaccone, Vincenzo
Gasbarrini, Antonio
Addolorato, Giovanni
De Cosmo, Salvatore
Mirijello, Antonio
Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title_full Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title_fullStr Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title_full_unstemmed Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title_short Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis
title_sort delta-procalcitonin and vitamin d can predict mortality of internal medicine patients with microbiological identified sepsis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066199/
https://www.ncbi.nlm.nih.gov/pubmed/33915819
http://dx.doi.org/10.3390/medicina57040331
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