The crude ICU mortality was also considered.Measurement of the procalcitonin levelThe Kryptor? immunoassay was used according to the manufacturer’s instructions selleck chemicals Bortezomib (Brahms, Hennigsdorf, Germany). The functional sensitivity of the assay is 0.06 ng/ml. Patients for whom the PCT measurement was either unavailable or were not performed within the 12 hours following the blood sample were excluded from further analysis because of the risk of false-negative results.Statistical analysisValues are expressed as the mean �� standard deviation unless otherwise stated. PCT levels were log-transformed for all analyses. PCT kinetics are expressed as ��PCT values. ��PCT was defined as the difference between two subsequent values.

For example, ��PCT D2�CD3 was the difference in PCT between the second and third days (��PCT D2�CD3 = PCT-D3 �C PCT-D2) following the onset of sepsis (that is, D1). As a result, ��PCT D2�CD3 > 0 if PCT had increased from D2 to D3. ��PCT was also expressed as proportions. For example, ��PCT D2�CD3 > 50% meant that PCT has increased by more than 50% between D2 and D3.Continuous variables were compared with the Mann�CWhitney U test. Categorical variables were compared using the chi-square test. We then examined the independent contribution of factors that had been predictive of death in the ICU by univariate analysis. Prior to logistical regression, conformity with the linear gradient of each continuous variable was checked. If the linear model was not appropriate to describe its variations, the variable was transformed according to the parcimonious rule.

The candidate variables were then manually entered into a logistical regression model if the associated regression coefficient had P < 0.20 by univariate analysis, and then removed if P > 0.05 was obtained by multivariate analysis.It is worth noting that the SAPS II was not entered into the model regardless of the value obtained by univariate analysis. Actually, it has been established that the SAPS II has been validated in a large cohort of patients with various conditions different from sepsis. As a result, although this score is thought to provide a reliable assessment of the mortality risk, it does not specifically measure the risk of death from infectious causes. In addition, since sepsis onset does not always occur on admission, the SAPS II value does not necessarily reflect a patient’s condition at this time, especially in terms of organ dysfunction and failure.

Actually, sepsis was an ICU-acquired condition in more than one-third of our patients (data not shown). Finally, the sequential measurement of the SAPS II has not yet been validated. The SOFA score was therefore calculated daily during the course of sepsis, and Cilengitide was preferred to the SAPS II as a predictive model of organ dysfunction and outcome.