Prognostic Value of Semiquantitative Serum Procalcitonine Vs Apache or Sofa Scores in Patients with Descending Necrotizing Mediastinitis

Descending necrotizing mediastinitis has a high mortality rate which is estimated around 40%. It does not exist an outcome prediction score based on clinical or laboratory studies that evaluate the severity and prognosis of patients with this condition. The aim of this study is to assess the prognostic value of Procalcitonine C on mortality of patients with descending necrotizing mediastinitis. Material and Methods: We performed a prospective, descriptive study from march 2008 to june 2011. Procalcitonine values and APACHE and SOFA scores were evaluated at the time of admission, on the 3rd and 7th intrahospital day in patients with the diagnosis of descending necrotizing mediastinitis. Values of Procalcitonine >10 ng/dL, APACHE ³ 25 points and SOFA ³8 points are considered very grave. Results: Thirteen patients with the diagnosis of descending necrotizing mediastinitis were evaluated. The mean age was 41.8 ± 12.3 years (15-59 years old). There were 7 (53.8%) females and 6 (46.2%) males. At the time of admission all the patients presented with Procalcitonine levels higher than 10 ng/dL; on the 3rd intrahospital day eight patients (61%) had levels higher than 10 ng/dL. Three patients with Procalcitonine levels >10 ng/dL died on the first intrahospital week. At the time of admission, 8 patients (69%) had APACHE score ³ 25 points and 5 (31%) < 25 points. The 3 patients that died on the first week of intrahospital stay had APACHE < 25 points and SOFA score < 8 points. Conclusions: We can conclude that procalcitonine levels can be a reliable prognostic tool in patients with descending necrotizing mediastinitis even better than APACHE and SOFA scores.