Procalcitonin as a predictor of prognosis in patients with bacteremia admitted to the intensive care unit
DOI:
https://doi.org/10.61529/idjp.v35i3.587Abstract
Background: The study aimed to determine the association between procalcitonin levels and clinical outcomes in patients with bacteremia admitted to the intensive care unit and to compare procalcitonin levels between community-acquired and hospital-acquired bacteremia.
Material and Methods: A prospective observational longitudinal study was conducted from 1st September 2025 to 28th February 2026 in the adult intensive care units of Mem on Medical Institute Hospital, Karachi. Using consecutive sampling, a total of 199 adult patients with proven bacteremia were enrolled. The Roche Cobas e411 ECLIA platform was used to measure procalcitonin levels at admission, day 5, and day 10. Hospital mortality was the primary outcome. Data were analyzed using SPSS version 26.
Results: Among 199 ICU patients with bacteremia, the median age was 53.5 years, and 59.3% were male; sepsis was the most common diagnosis (31.2%). Median procalcitonin (PCT) levels declined from 8.90 ng/mL at baseline to 5.70 and 3.60 ng/mL on days 5 and 10, respectively. PCT levels were significantly higher in hospital-acquired than community-acquired bacteremia at all three time points (p≤0.009). Baseline PCT was highest among non-survivors (14.80 ng/mL), compared with survivors (6.40 ng/mL) and patients leaving against medical advice (9.60 ng/mL). Mortality increased significantly with rising PCT levels, from 7.5% for PCT 10 ng/mL (p<0.001).
Conclusion: Higher baseline procalcitonin levels were significantly associated with mortality among ICU patients with bacteremia. Procalcitonin levels were also significantly higher in patients with hospital-acquired bacteremia compared with those with community-acquired bacteremia.
Keywords: Bacteremia, Hospital-acquired bacteremia, Intensive care unit, Mortality, Procalcitonin, Prognosis.
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