Prognostic role of serum procalcitonin in neonatal sepsis at a tertiary care hospital.

Abstract

Objective: To analyze the prognostic role of serum procalcitonin in neonatal sepsis at a tertiary care hospital. Study Design: Cross-sectional study. Setting: Department of Pediatric, Dr. Ziauddin University Hospital, Kemari, Karachi, Pakistan. Period: October 2023 to March 2024. Methods: Neonates of both genders aged between 1 to 28 days having confirmed neonatal sepsis were included. At baseline, demographic characteristics were noted and necessary laboratory investigations were performed. At baseline, serum procalcitonin levels were evaluated in all neonates. The prognostic value of baseline PCT was assessed by comparing its association with the mortality. Other outcome variables like need for non-invasive ventilation, mechanical ventilation, need for inotropics, and acute kidney injury were also documented. Results: In a total of 131 neonates, 76 (58.0%) were male. The median age was 2.00 days (IQR=1-7 days). The median baseline procalcitonin level was 3.17 ng/ml (IQR=0.55 to 10.34 ng/ml). Need for non-invasive ventilation, and mechanical ventilation was noted in 93 (71.0%), and 19 (14.5%) neonates, respectively. Need for inotropics was documented in 23 (17.6%) neonates. The median duration of NICU stay was 3.00 (2.00-5.00 days). Among neonates who died, procalcitonin levels were significantly higher than those who survived (p=0.015). Mortality was found to have significant association with need for mechanical ventilation (p<0.001), and need for inotropics (p<0.001). Conclusion: High serum procalcitonin was found to be a significant predictor of mortality in neonatal sepsis. Mortality was significantly associated with need for mechanical ventilation, and need for inotropics.