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The usefulness of C-reactive protein and procalcitonin to predict prognosis in septic shock patients: A multicenter prospective registry-based observational study

 Seung Mok Ryoo  ;  Kap Su Han  ;  Shin Ahn  ;  Tae Gun Shin  ;  Sung Yeon Hwang  ;  Sung Phil Chung  ;  Yoon Jung Hwang  ;  Yoo Seok Park  ;  You Hwan Jo  ;  Hyung Lan Chang  ;  Gil Joon Suh  ;  Kyoung Min You  ;  Gu Hyun Kang  ;  Sung-Hyuk Choi  ;  Tae Ho Lim  ;  Won Young Kim  ;  Korean Shock Society (KoSS) Investigators 
 SCIENTIFIC REPORTS, Vol.9(1) : 6579, 2019 
Journal Title
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The objective of this study was to evaluate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and their combination for mortality in patients with septic shock. This multicenter, prospective, observational study was conducted between November 2015 and December 2017. A total of 1,772 septic shock patients were included, and the overall 28-day mortality was 20.7%. Although both CRP and PCT were elevated in the non-survivor group, only CRP had statistical significance (11.9 mg/dL vs. 14.7 mg/dL, p = 0.003, 6.4 ng/mL vs. 8.2 ng/mL, p = 0.508). Multivariate analysis showed that CRP and PCT were not independent prognostic markers. In the subgroup analysis of the CRP and PCT combination matrix using their optimal cut-off values (CRP 14.0 mg/dL, PCT 17.0 ng/dL), both CRP and PCT elevated showed significantly higher mortality (Odds ratio 1.552 [95% Confidence intervals 1.184-2.035]) than both CRP and PCT not elevated (p = 0.001) and only PCT elevated (p = 0.007). However, both CRP and PCT elevated was also not an independent predictor in multivariate analysis. Initial levels of CRP and PCT alone and their combinations in septic shock patients had a limitation to predict 28-day mortality. Future research is needed to determine new biomarkers for early prognostication in patients with septic shock.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Hwang, Yoon Jung(황윤정) ORCID logo https://orcid.org/0000-0001-7286-7699
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