Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients

Manas, Siti Afifah Abd (2023) Early predictive value of procalcitonin to albumin ratio for intensive care unit mortality in severe sepsis patients. Masters thesis, Universiti Sains Malaysia.

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Abstract

Objective: High procalcitonin (PCT) and low albumin (ALB) concentrations have been associated with mortality in sepsis. The present study aimed to investigate the prognostic value of PCT to ALB ratio (PCT: ALB) for ICU mortality in septic patients. Methods: This was a registry based retrospective observational study conducted in the Intensive Care Unit (ICU) of Hospital Universiti Sains Malaysia over a 3-year period. Consecutive adult patients admitted to the ICU who underwent simultaneous measurement of PCT and ALB who fulfilled the Sepsis-3 criteria were recruited. Serum PCT was measured with a point-of-care analyzer available in the ICU (Finecare™ PCT Rapid Test). Predictive performance of PCT: ALB was assessed by analysis of the receiver-operating characteristic (ROC) curve. Results: A total of 185 sepsis patients were recruited. The primary outcome of all-cause ICU mortality was 35.1%. Baseline PCT was significantly higher while baseline ALB was significantly lower in the non-survivors compared to the survivors [9.8 (IQR 2.64 - 40.65) vs 2.07 (IQR 0.55 – 9.08) ng/mL and 26 (SD = 5) vs 30 (SD = 6) g/L, respectively, P <0.001]. The computed PCT: ALB was significantly higher in the non-survivors compared to the survivors [0.40 (IQR 0.11 – 1.63) vs 0.06 (IQR 0.02 – 0.31), P <0.001]. The area under the ROC curve of PCT: ALB for discrimination of ICU-mortality was 0.731 (95% CI 0.615-0.840) which was higher than PCT alone (AUC 0.721, 95% CI 0.651-0.785). The ideal cut-off value for PCT: ALB was 0.12 with sensitivity of 73.85% and specificity of 60.83%. Conclusion: PCT: ALB is a potentially reliable tool to aid in the mortality prediction of sepsis although this requires further validation in a prospective multi-center study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: procalcitonin, low albumin
Subjects: R Medicine
R Medicine > RC Internal medicine > RC31-1245 Internal medicine
Divisions: Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis
Depositing User: MUHAMMAD AKIF AIMAN AB SHUKOR
Date Deposited: 14 Aug 2025 01:47
Last Modified: 02 Sep 2025 07:41
URI: http://eprints.usm.my/id/eprint/62761

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