Abstract
In this prospective study, we evaluated the use of PCT when collecting the body which was carried out. The chosen cut-off was set at 10 ng/mL because at this level, the PCT was associated to a multiorgan failure attributable to a septic shock.For 90 cases, two groups were stratified by their final diagnosis: 33 of for non violent deaths and 57 of violent deaths. There was no significant elevation of procalcitonin rate (PCT) in the group of violent deaths. We noted 6 elevations of PCT rate above 10 ng/mL for non violent deaths (15.4%) and in 3 cases there wasan evidence for an infectious context (recent anti- infectious treatments, chemotherapy in progress).Control of CRP performed on blood samples found initial elevations above 10 mg/L in 3 of the 6 cases (including 2 of 3 cases associated with an infectious context). There is no evidence of PCT rate increase for intermediate PMI (post mortem interval), long PMI and undefined PMI. This study found a PPV (positive predictive value) and clinical specificity of 100% for a cut-off set at 10 ng/mL. By taking this threshold, no significant PCT increase was observed in presence of death cases related to a violent origin as well as a fatal multiorgan failure due to malignant hyperthermia syndrome induced by neuroleptic use. The PCT appears to remain stable over time and whatever the conservation conditions of the body.
Highlights
In 2007, INSERM [1] reported, in France, 34 703 deaths of unknown cause or ill-defined (6.7% of all deaths)
We noted 6 elevations of procalcitonin rate (PCT) for non violent deaths (15.4%) and in 3 cases there was an evidence for an infectious context
In a case of non violent death with negative PCT test with a short post mortem interval (PMI) and neuroleptic treatment, we found the temperature body abnormally elevated in regard to the PMI: these findings permitted to determine a probable neuroleptic malignant diagnostic
Summary
In 2007, INSERM [1] reported, in France, 34 703 deaths of unknown cause or ill-defined (6.7% of all deaths). Sands reported in his study, a 2% rate of death due to sepsis occurred in academic tertiary care centers [4]. In this context the PCT, the 116 amino acid precursor of calcitonin, is a recognized marker of sepsis in clinical practice [5] and has been validated in post-mortem analysis. The chosen cut-off is set at 10 ng/mL. At this level, the PCT is associated with a multi-organ failure attributable to a septic shock. We evaluated the use of PCT when collecting the body carried out
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