Diagnostic Value of Procalcitonin in Patients with Heat Stroke

Author(s): Xuan Song, Xinyan Liu, Huairong Wang, Xiuyan Guo, Maopeng Yang, Daqiang Yang, Yahu Bai, Nana Zhang, Chunting Wang

Background: Heat stroke is a life-threatening disease, but there is currently no biomarker to accurately assess prognosis.

Objective: To study whether serum procalcitonin (PCT) is an effective biomarker for evaluating the prognosis for patients with heat stroke.

Method: Clinical data for 61 patients with heat stroke were retrospectively collected and analyzed. PCT, Acute Physiology and Chronic Health Evaluation (APACHE II) score and Multiple Organ Dysfunction Score (MODS) were calculated within the first 24 hours of admission to the ICU. The ability of PCT, APACHE II score, and MODS score to predict prognosis was assessed using a receiver operating characteristic curve (ROC) and area under the curve (AUC) analyses.

Result: There was no statistical difference in the PCT value on admission to the intensive care unit (ICU) (PCT1) between the survivors and non-survivors (3.27 [95% CI 0.15-13.55] vs 0.45 [95% CI 0.13-2.04], p=0.369). ROC curve analysis showed that AUC of APACHE II score and MODS score were 0.932 (95% CI 0.861-1.000), p<0.001 and 0.857 (95% CI 0.744- 0.970), p<0.001, respectively. The AUC of PCT1 was 0.599 (95% CI 0.353-0.846), p=0.370. The dynamic trend of PCT was also not statistically different between the survivor and non-survivor group (p=0.138).

Conclusion: PCT and its dynamic trend do not provide a good assessment of the prognosis for patients with heat stroke. An increase in PCT levels at ICU admission is not an indicator of bacterial infection, which should be confirmed by larger future studies.