Use of procalcitonin for early prediction of lethal outcome of postoperative sepsis

Am J Surg. 2007 Jul;194(1):35-9. doi: 10.1016/j.amjsurg.2006.10.026.


Background: To develop strategies for the prediction of sepsis outcome systemic procalcitonin (PCT) levels were correlated with various clinical parameters.

Methods: PCT levels and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were assessed on the day of sepsis diagnosis in a large series (n = 160) of patients developing sepsis after major visceral surgery.

Results: In multivariate analysis, systemic PCT and the APACHE II score could be identified as independent early predictive indicators of lethal sepsis. Combining both indicators at sepsis onset, a prognosis score could be calculated using binary logistic regression analysis allowing the identification of high- and low-risk groups. While 71% of the high-risk patients died of sepsis, 77% of patients assigned to the low-risk group survived the septic complication (sensitivity 71%, specificity 77%).

Conclusion: Calculation of the prognosis-score allowed for an early prediction of the septic course with high sensitivity and specificity. This information could aid in deciding on adequate treatment strategies.

MeSH terms

  • Aged
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / mortality*
  • Predictive Value of Tests
  • Prognosis
  • Protein Precursors / blood*
  • Sepsis / blood
  • Sepsis / etiology*
  • Sepsis / mortality*


  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide