Journal
JOURNAL OF CRITICAL CARE
Volume 33, Issue -, Pages 240-244Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2016.02.006
Keywords
Adverse outcomes; Clinical indicators; Critical illness; Discharge; Quality
Categories
Funding
- Raine Medical Research Foundation
- WA Department of Health through Raine Clinical Research Fellowship
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Procalcitonin (PCT) has been used to guide treatment in critically ill patients with sepsis, but whether PCT at intensive care unit (ICU) discharge can stratify risks of post-ICU readmission or modality is unknown. This cohort study compared the ability of PCT with &reactive protein (CRP) in predicting unexpected adverse post-ICU events. Of the 1877 patients admitted to the multidisciplinary ICU between 1 April 2012 and 31 March 2014, 1653 (S8.1%) were discharged without treatment limitations. A total of 71 (43%) were readmitted and 18 patients (1%) died unexpectedly after ICU discharge during the same hospiLilizalion. Both PCT (0.6 vs 0.4 mil., P < .002) and a high CRP concentration >100 mg4 (58% vs 41%, P = .004) at ICU discharge were associated with an increased risk of adverse post ICU events in the univariate analyses; however, the ability of PCT to discriminate between patients with and without adverse post -ICU outcomes was limited (area under the receiver operating characteristic curve 0.61; 95% confidence interval, 055-0.66). In the multivariable analysis, only a high CRP concentration (odds ratio, 1.92; 95% confidence interval, 1.12-3.11; P.00S) was associated with an increased adverse post-1CU events. Elevated PCT concentration at ICU discharge was inadequate in its predictive ability to guide ICU discharge. Crown Copyright (C) 2016 Published by Elsevier Inc. All rights reserved.
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