[Value of procalcitonin in predicting the severity and prognosis of neonates with septicemia].

Objective: To explore the value of procalcitonin(PCT) in predicting the severity and prognosis of neonates with septicemia. Methods: The clinical data of the hospitalized neonates over the age of 72 hours with double positive blood cultures from December 1st, 2011 to September 30, 2017 at the neonatal intensive care unit of Children's Hospital Affiliated to Capital Institute of Pediatrics was analyzed retrospectively. Results: A total of 75 neonates were included in the study. There was a significant negative correlation between PCT and neonatal critical illness score ( r =-0.440, P <0.05). Among the groups of non-critical, critical and extremely critical, the levels of PCT had significant difference [0.27(0.10-2.55), 4.34(1.24-20.32), 19.49(1.92-106.49)μg/L, H =20.717, P <0.01]. At a cut-off point of 0.56 μg/L, PCT showed 88.6% sensitivity and 61.3% specificity for critical group diagnosis, with optimal area under the curve of 0.804 ( P <0.05). At a cut-off point of 11.45 μg/L, PCT showed 65.2% sensitivity and 82.7% specificity for extremely critical group diagnosis, with optimal area under the curve of 0.735 ( P <0.05). Among the groups of none organ dysfunction, single organ dysfunction and shock or multiple organ dysfunction, the levels of PCT had significant difference[0.10(0.43-2.56), 3.18(0.67-20.95), 18.97(1.92-82.90) μg/L, H =20.299, P <0.01]. At a cut-off point of 2.64 μg/L, PCT showed 70.0% sensitivity and 77.1% specificity for single organ dysfunction diagnosis, with optimal area under the curve of 0.793 ( P <0.05). At a cut-off point of 9.06 μg/L, PCT showed 61.3% sensitivity and 86.4% specificity for shock or multiple organ dysfunction diagnosis, with optimal area under the curve of 0.782 ( P <0.05). PCT levels were significantly higher in the death group than the survival group. At a cut-off point of 75.65 μg/L, PCT showed 80.0% sensitivity and 90.0% specificity for the judgment of death, with optimal area under the curve of 0.886 ( P <0.05). C-reactive protein (CRP), white blood cell (WBC) and neutrophil lymphocyte ratio (NLR) had no significant difference in the severity and the degree of organ dysfunction of neonates with septicemia(all P >0.05). Conclusion: Compared to CRP, WBC and NLR, PCT has high value in predicting the severity, the degree of organ dysfunction and the prognosis of neonates with septicemia.