The research of the procalcitonin level in the diagnosis of severe infection disease with intracerebral bleeding

ABSTRACT THE RESEARCH OF THE PROCALCITONIN LEVEL IN THE DIAGNOSIS OF SEVERE INFECTION DISEASE WITH INTRACEREBRAL BLEEDING Central fever detection in patients following intensive care unit with intracerebral hemorrhage, is crucial for infectious patients with central fever, early diagnosis of infections, morbidity and mortality. For this reason, accurate and rapid results of laboratory tests are needed to provide diagnosis of central fever and fever due to infection. The aim of this study is to investigate whether systemic procalcitonin (PCT) levels may be used as a biomarker to detect febrile etiology in early stage in patients with intensive care unit due to intracerebral hemorrhage. In patients admitted to intensive care unit due to intracerebral hemorrhage (ICH); Fever etiology will be determined early, rational antibiotic use will be ensured, unnecessary use will be repeated, early diagnosis of existing infections will be made and besides prevention of morbidity and mortalityeconomic gain will be ensured. 73 patients with ICU who were followed up in the surgical / internal ICU were included in the study. Blood, urine, endotracheal aspirate (ETA) and wound cultures were taken in patients with high fever during or after admission to the YBU. Blood samples were collected and routinely replicated for C-reactive protein (CRP), PCT, leukocyte count, PMNL (plimorph-nuchal leucocyte) percentage and erythrocyte sedimentation rate (ESR). At the same time, the patient were divided into groups as deaths and survivors and the relationship between serum CRP, PCT, ESR, leukocyte and PMNL % levels and prognosis was examined. There was a statistically significant difference in PCT level between patients with intracerebral hemorrhage and those with central fever (p>0.05). When serum PCT levels were examined according to the focus of the infected patients, it was seen that the highest average was in patients with multiple infections. When analyzed according to the diagnoses, there was a statistically significant positive correlation between CRT levels and PCT levels in patients with infectious fever (r:0.461, p<0.05). However, in patients with central fever, there was no significant relationship between PCT levels and CRP levels (r:0.239, p>0.05). There was no statistically significant correlation between PCT levels and ESR, blood leukocyte levels and PMNL fractions in patients with infectious fever (p>0.05). Similarly, no statistically significant correlation was found between PCT levels and ESR, blood leukocyte levels and neutrophil percentages in central fever cases (p>0.05). No statistically significant correlation was found between PCT levels and CRP levels in all groups when infectious fever cases were grouped according to the foci of infections (p>0.05). PCT has been shown to be more successful in differentiating febrile infection from patients with intracerebral hemorrhage according to the percentage of CRP, ESH, leukocyte, and neutrophil. When the follow-up period of 73 patients followed up in the intensive care unit was examined, mean serum PCT levels were found to increase statistically significantly (p<0.05). When the PCT levels of the cases were compared according to the prognosis, it was determined that the initial PCT levels of the death cases were significantly higher than the discharge cases (p<0.05). As a result; It has been concluded that PCT is a biomarker that can be used in the intensive care unit with intracerebral hemorrhage in patients with febrile seizures, fever due to bleeding and fever due to infection. PCT can show not only a possible bacterial infection but also the prognosis and mortality of the infection. Keys words: Procalcitonin, Central Fever, Infection, Leukocyte, Neutrophil