Comparison of Lactate Clearance and Procalcitonin as Early Predictors of Mortality and Organ Dysfunction in Septic Patients

Background: Early prognostic assessment in sepsis remains crucial for optimal patient management and resource allocation.While both lactate clearance and procalcitonin have been proposed as biomarkers for sepsis prognosis, their comparative effectiveness for predicting mortality and organ dysfunction requires further investigation.To compare the prognostic value of lactate clearance and procalcitonin as early predictors of 28-day mortality and organ dysfunction in septic patients.Methods: This prospective observational cohort study was conducted in a 20-bed intensive care unit over 12 months.Forty adult patients diagnosed with sepsis according to Sepsis-3 criteria were enrolled.Blood samples for lactate and procalcitonin measurements were collected at baseline, 6, 12, 24, and 48 hours after ICU admission. Results:The study population had a mean age of 62.514.8 years with 30% mortality rate.Lactate clearance demonstrated superior prognostic performance compared to procalcitonin clearance.At 48 hours, lactate clearance achieved an area under the ROC curve of 0.88 (95% CI: 0.78-0.98)with an optimal cutoff <25% providing sensitivity 91.7% and specificity 85.7%.In contrast, procalcitonin clearance showed poor discriminatory ability across all time points (AUC range: 0.51-0.67).Survivors achieved significantly higher lactate clearance than non-survivors at 48 hours (52.129.6% vs. -18.338.7%,p<0.001).Conclusions: Lactate clearance, particularly when assessed over 48 hours, provides superior prognostic information compared to procalcitonin clearance for predicting mortality and organ dysfunction in septic patients, supporting its prioritization in clinical decision-making and sepsis management protocols.