Dynamic changes and prognostic utility of procalcitonin, D-dimer, and lactate dehydrogenase in patients with sepsis and septic shock.

OBJECTIVE

To investigate whether serum levels of procalcitonin (PCT), D-dimer (D-D), and lactate dehydrogenase (LDH) are associated with disease severity and differ between patients with sepsis with favorable versus poor in-hospital outcomes.

METHODS

This retrospective cohort study included 171 patients with sepsis. Patients were stratified into a septic shock group (n = 49) and a non-shock sepsis group (n = 122) to assess disease severity and further categorized into an improved group (n = 127) and a poor prognosis group (n = 44) based on discharge outcomes to evaluate prognostic value. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with septic shock. Dynamic trajectories of PCT, D-D, and LDH levels during hospitalization were also analyzed.

RESULTS

On admission, levels of PCT, D-D, and LDH were significantly higher in the septic shock group than in the non-shock sepsis group (all p < 0.01). In the multivariable model, elevated levels of PCT (OR = 1.015, 95% CI: 1.002-1.028), D-D (OR = 1.087, 95% CI: 1.010-1.170), and LDH (OR = 1.265, 95% CI: 1.016-1.576) were independently associated with an increased likelihood of septic shock. Patients with a poor prognosis exhibited persistently elevated levels of all three biomarkers throughout hospitalization, whereas these levels decreased significantly in the improved group.

CONCLUSION

PCT, D-D, and LDH are valuable biomarkers for stratifying disease severity and predicting clinical outcomes in patients with sepsis. Admission levels of these biomarkers were independently associated with the development of septic shock, and their dynamic changes provided additional prognostic information.