Abstract

Objective: To describe serum procalcitonin (PCT) in pediatric severe sepsis and assess its prognostic value for septic shock and mortality.
Methods: Longitudinal study of 78 children (1 month–15 years) with severe sepsis/septic shock at Hue Central Hospital (Jan 2022–May 2024). Clinical–laboratory data and PCT were collected; ROC analysis determined optimal cut-offs.
Results: Median age 29 months; males 56.4%. Severe sepsis 64.1%, septic shock 35.9%. Median PCT 27.2 ng/mL (IQR 7.6–54.9). PCT was higher with positive blood cultures (47.8 vs 24.2 ng/mL; p<0.05). ROC AUC for predicting septic shock was 0.757 with an optimal cut-off of 19.7 ng/mL (sensitivity 81%, specificity 70%); ROC AUC for mortality was 0.779 with a cut-off of 37.8 ng/mL (77%/77%). Mortality/discharge in moribund status was 44.9%, higher in septic shock (71.4% vs 30.0%; p<0.01).
Conclusions: Elevated PCT is associated with severity and provides fair-to-good prognostic performance for shock and mortality. Cut-offs of 19.7 and 37.8 ng/mL may aid early risk stratification.