OBJECTIVE To explorer the association between the clearance of serum procalcitonin (PCTc) and the risk of 28-day in-hospital mortality of the sepsis patients.

METHODS A total of 270 patients who were diagnosed with sepsis in Huiya Hospital, the First Affiliated Hospital of Sun Yat-sen University from Jan. 2022 to Jan. 2025 were recruited as the research subjects and were divided into the low decline group with 76 cases, the moderate decline group with 74 cases and the high-level stability group with 120 cases according to the change of serum PCTc within 1 to 7 days after the admission. The association between the trajectory of change of PCTc and the risk of 28-day mortality of the sepsis patients was observed by Cox regression analysis method. The rough risk ratios (RRs) of complications of the different changing trajectories of PCTc were calculated by binary log-binomial regression model.

RESULTS The red blood cell (RBC) counts, white blood cell (WBC) counts, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) were higher in the low decline group than in the moderate decline and the high-level stability group (P < 0.05); while the levels of platelet (PLT) and fibrinogen (FIB) of the high-level stability group were higher than those of the low and moderate decline group (P < 0.05). Kaplan-meier survival curve analysis showed that the accumulative survival rate was 46.62% in the low decline group, 64.31% in the moderate decline group and 81.24% in the high-level stability group, there was significant difference (χ²=25.479, P < 0.001).

CONCLUSION The trajectory of change of PCTc can be served as an early-warning index for the risk of in-hospital mortality and complications, which may provide important basis for development of individualized treatment program.