Serum Procalcitonin for Predicting Significant Infections and Mortality in Pediatric Oncology.

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Serum Procalcitonin for Predicting Significant Infections and Mortality in Pediatric Oncology.

Indian Pediatr. 2016 Dec 15;53(12):1075-1078

Authors: Gunasekaran V, Radhakrishnan N, Dinand V, Sachdeva A

Abstract
OBJECTIVE: To evaluate the role of serum procalcitonin (PCT) level at admission in predicting significant infections and deaths among children on chemotherapy presenting with fever.
METHODS: Children with clinically significant (CSI) and microbiologically documented (MDI) infections were identified using standard definitions. Association of PCT with CSI, MDI and mortality was analyzed.
RESULTS: We evaluated 821 febrile episodes in 316 children. CSI, MDI and deaths were seen in 40.9%, 20.1% and 2.9%, respectively. PCT levels ranged from 0.05-560ng/mL. Median PCT was higher in episodes with CSI (0.80 vs. 0.28) and MDI (0.71 vs. 0.34) (P<0.001). PCT ≥0.7ng/mL optimally predicted CSI (AUC-0.740) and MDI (AUC-0.636). Relative risk of mortality for PCT ≥5ng/mL was 7.1. PCT ≥0.7ng/mL had poor sensitivity (45-55%) but good specificity and NPV (70-90%). PCT was elevated in nearly half of documented viral and fungal infections.
CONCLUSION: PCT predicts significant infections and mortality in pediatric oncology but it has poor sensitivity to guide clinical decisions.

PMID: 27889712 [PubMed - indexed for MEDLINE]