Prognostic Value of Variations in Serum Biomarkers and Prognostic Scores Values between Admission and Second day in Intensive Care Unit Septic patients

Abstract Background: To determinate the prognostic value of procalcitonin (PCT) and C-reactive protein (CRP) changes during the first two days of admission to the ICU with sepsis and/or septic shock, and to compare it with changes in Acute Physiology And Chronic Health Evaluation II (APACHE-II) and Sepsis-related Organ Failure Assessment (SOFA) prognostic scores. Methods: Prospective cohort observational study. 50 consecutive patients admitted to a single-center ICU. Results: Aged 67(52-75) years with APACHE-II 19(14-25) and SOFA scores 7(5-11) points on admission, and a recorded 28-day mortality of 42%. There were no significant differences observed between APACHE II, SOFA, PCR nor PCT in the survival versus the non-survival group on the day of admission. APACHE II (p=0,001) and SOFA (p=0,002) between admission and second day raised significantly in no survivors, with no significant changes in CRP and PCT. Mortality was significantly associated with a raise in APACHE-II and SOFA scores between admission and second day (OR:2.13,1.18-3.86) but not with PCT nor CRP changes.Conclusions: Changes in SOFA and APACHE II scores between admission and second day in ICU septic patients are more sensitive mortality predictors than the observed changes in CRP and PCT values.