Predictive value of procalcitonin in intensive care unit delirium.
10.3760/cma.j.issn.2095-4352.2018.07.009
- Author:
Jiru YE
1
,
2
,
3
,
4
,
5
;
Jing WANG
;
Feng ZHENG
;
Xiaonan SHAO
;
Suhong WANG
;
Haoqian GAO
Author Information
1. Department of Respiratory Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China (Ye JR)
2. Department of Infectious Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China (Wang J)
3. Department of Intensive Care Unit, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China (Zheng F, Gao HQ)
4. Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China (Shao XN)
5. Department of Psychiatric Medicine, the Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China (Wang SH). Corresponding author: Zheng Feng, Email: 751429157@qq.com.
- Publication Type:Journal Article
- MeSH:
C-Reactive Protein;
Calcitonin;
Calcitonin Gene-Related Peptide;
Delirium;
Humans;
Intensive Care Units;
Prognosis;
Retrospective Studies;
Sepsis
- From:
Chinese Critical Care Medicine
2018;30(7):662-666
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the risk factors of delirium in intensive care unit (ICU) patients, and to investigate the predictive value of C-reactive protein (CRP), procalcitonin (PCT), lactic acid (Lac) and neuron-specific enolase (NSE) in the diagnosis of ICU delirium.
METHODS:The patients admitted to central ICU and respiratory medicine ICU of Changzhou First People's Hospital from August 2016 to November 2017 were enrolled. The patients were divided into two groups according to whether delirium occurred within 7 days or not, which was evaluated by using the confusion assessment method for ICU (CAM-ICU). The gender, age and blood CRP, PCT, Lac, NSE levels were compared between the two groups. Multivariate Logistic regression model was used to analyze the risk factors of ICU delirium. Receiver operating characteristic curve (ROC) was drawn to assess the predictive value of CRP, PCT, Lac and NSE in the occurrence of ICU delirium.
RESULTS:133 patients were enrolled. Delirium occurred in 67 patients, and did not occurred in 66 patients, with a prevalence rate of 50.4%. (1) There was no significant difference in gender or age between the two groups. Compared with non-delirium group, blood CRP, PCT and Lac levels in delirium group were significantly increased [CRP (mg/L): 110.75±77.31 vs. 51.32±36.51, PCT (μg/L): 3.95 (1.01, 23.90) vs. 0.09 (0.06, 0.36), Lac (mmol/L): 2.40 (1.70, 4.30) vs. 1.20 (0.90, 2.00), all P < 0.01], but no significant difference was found in NSE [μg/L: 12.59 (9.61, 17.69) vs. 13.39 (10.14, 19.05), P > 0.05]. (2) It was shown by multivariate Logistic regression analysis that blood PCT and Lac were risk factors of ICU delirium [PCT: odds ratio (OR) = 1.185, 95% confidence interval (95%CI) = 1.006-1.396, P = 0.042; Lac: OR = 1.398, 95%CI = 1.011-1.934, P = 0.043]. (3) ROC curve analysis showed that blood CRP, PCT and Lac had certain predictive value for ICU delirium, and the area under the ROC curve (AUC) of PCT was the highest (0.840 vs. 0.694 and 0.751). When the cut-off value of PCT ≥ 0.55 μg/L, the sensitivity was 72.7%, the specificity was 86.2%, positive predictive value was 84.48%, and negative predictive value was 75.68%. Blood NSE had no predictive value for ICU delirium (AUC = 0.446, P = 0.290).
CONCLUSIONS:Blood PCT and Lac are the risk factors of ICU delirium. PCT has predictive value for ICU delirium.
