PCT/ALB Ratio in Initial Three days for the Prediction of Secondary Infection in Septic Patients

Background: Procalcitonin (PCT) to albumin (ALB) ratio (PAR) in initial three days is a rapidly available indicator to assess the prognosis of patients with sepsis. This study aims to explore the correlation between changes in PAR during the initial 72 hours and the incidence of secondary infections. Methods: A total of 147 patients with sepsis were included in this study. Patients divided into secondary infection and without secondary infection group, according to whether they had secondary infection. PAR was calculated as serum PCT (ng/mL)/ALB (mg/mL). All statistical analyses were performed using the statistical package SPSS 20.0. Results: Compared with the without secondary infection group, the median APACHE II (22[17– 30] vs 16[11– 25]; p=0.009) were significantly higher in the secondary infection group. And the median ΔPCT/ALB adm-72h (0.10[0.02– 0.48] vs 0.17[0.03– 0.65]; p=0.011) were significantly lower in the secondary infection group. On multiple logistic regression, lower ΔPCT/ALB adm-72h was independently associated with the secondary infection. Decreasing quartile of ΔPCT/ALB adm-72h was statistically significantly associated with secondary infection, particularly among survivors. Conclusion: The decline in the PCT/ALB ratio over the initial 72 hours of the acute phase of sepsis serves as an association for the onset of secondary infections during a septic patient's hospitalization. Keywords: sepsis, PCT, secondary infection, biomarker