The prognostic value of procalcitonin, C-reactive protein and cholesterol in patients with an infection and multiple organ dysfunction

BACKGROUND To establish the prognostic value of procalcitonin, C-reactive protein and cholesterol levels for mortality in patients with an infection and multiple organ dysfunction. METHODS A prospective case-control study was performed, including 67 patients admitted to the intensive care unit with an infection and multiple organ dysfunction in whom cholesterol, procalcitonin, and C-reactive protein levels were measured on admission and during the course of treatment. RESULTS The associations between in-hospital mortality and procalcitonin, C-reactive protein, and cholesterol levels were analyzed. Logistic regression analysis showed that cholesterol (odds ratio [OR], 1.858; 95% CI, 1.170-2.949; P = 0.009) and C-reactive protein (OR, 4.408; 95% CI, 2.019-9.624; P < 0.001) levels were predictors of mortality. A receiver operating characteristic curve analysis yielded an area under the curve (AUC) of 0.774 and 95% CI of 0.693-0.855 (P < 0.001) for C-reactive protein, an AUC of 0.66 and 95% CI of 0.535-0.784 (P = 0.019) for procalcitonin, and an AUC of 0.654 and 95% CI of 0.593-0.715 (P < 0.001) for cholesterol as predictors of mortality. When combined with the bioscore system for mortality, these markers yielded an AUC of 0.845 and 95% CI of 0.770-0.921 (P < 0.001), with sensitivity of 89.1% and specificity of 83.1%. CONCLUSIONS The combination of procalcitonin, C-reactive protein, and cholesterol levels in a single scoring system yielded high predictive value for mortality.