Japanese Society for Infection Prevention and Control-Online Journal

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Article in Japanese

Short-term Prognostic Factors of Patients with Fever and Elevated Serum Procalcitonin

Hideki NISHIYAMA, Norihiro YUASA, Makoto MINOSHIMA, Yoshiko OZAWA, Kumiko TAKASAKA, Yasumasa KURONO, Fumio NOMURA and Koichi MIYAMURA
Nosocomial Infection Control Committee, Japanese Red Cross Nagoya Daiichi Hospital

It is important for an infection control team to detect patients with severe infection and promote physicians in prompt adequate therapy. The aim of this study was to identify short-term prognostic factors in patients with fever and elevated serum procalcitonin. A total of 425 patients (investigation group, n = 217 and validation group, n = 208) who had fever of more than 38°C and elevated procalcitonin of more than 2.0 ng/mL were included. Four factors, including C-reactive protein ≥ 22.57 mg/dL, serum albumin < 2.8 g/dL, blood urea nitrogen ≥ 32 mg/dL, and red cell distribution width ≥ 15.3, were significant independent prognostic factors for 30-day survival in multivariate analysis of the investigation group. Four variables, which were assigned 1 point each, were used to create a prognostic score (PS). 30-day survival was significantly worse in the elevated PS: 100%, 85%, and 64% in PS: 0, PS: 1/2, and PS: 3/4, respectively (p = 0.0010). The 30-day survival of validation group was well stratified by PS: 90%, 81%, and 52% in PS: 0, PS: 1/2, and PS: 3/4, respectively (p = 0.0001). Among patients with fever and elevated serum procalcitonin, a proposed scoring system may identify patients most likely to benefit from ICT assistance.

Key words：infection disease, fever, procalcitonin, prognostic factor

e-mail: mammoth243＠yahoo.co.jp

Received: May 12, 2017
Accepted: October 16, 2017

33 (1)：15─23,2018