Valor de la procalcitonina com a marcador pronòstic en el pacient politraumàtic en una unitat de cures intensives pediàtrica

Background: Severe polytrauma (PT) is associated with a high morbidity and mortality. Procalcitonin (PCT) may be a useful prognostic indicator. Objective: To describe the levels of PCT in the polytraumatized patient (PTP) and to determine its prognostic implications. Method: This was a prospective observational study conducted between November 2009 and November 2011. The inclusion criteria were age less than 16 years, admission for PT in the Pediatric Critical Care Unit, and availability of PCT values on admission and for 24-48 hours. Statistical analysis was with SPSS version 17.0 package. Results: Twenty of the 67 PTP met the inclusion criteria. The mean age was 13.6±4.2 years, and 19 (95%) were male. The Pediatric Risk of Mortality Score Index (PRISM-MI) was 9.8±7.3, and the Pediatric Trauma Score was 5.5±2.0. Mean PCT levels at 24 hours from admission were 7.6±18.0 ng/ml. In eight cases the diagnosis of a concurrent bacterial infection was made. There were no deaths. PCT correlated with PRISM-MI score (R 0.6, p=0.048). Mean PCT levels were significantly higher in the group of patients that required mechanical ventilation, compared to those who did not require it (p=0.046) and in those with a concurrent infection (p=0.039). There was a tendency for the mean PCT values on admission to correlate with the length of hospital stay (R 0.393, p=0.1). Conclusions: Due to the high frequency of bacterial infections that PCT values were high in our study. PCT levels may be useful as prognostic factor.