ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Dynamic Changes and Prognostic Utility of Procalcitonin, D-dimer, and Lactate Dehydrogenase in Patients with Sepsis and Septic Shock
Qiuxia Ge
Weijuan Song
Ding Hongmei
Haojie Wu
Zhen Ren
First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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Abstract
Objective To investigate whether serum levels of procalcitonin (PCT), D-dimer (D-D), and lactate dehydrogenase (LDH) are associated with disease severity and differ between patients with sepsis with favorable versus poor in-hospital outcomes. Methods This retrospective cohort study included 171 sepsis patients. Patients were stratified into a septic shock group (n = 49) and a non-shock sepsis group (n = 122) to assess disease severity, and further categorized into an improved group (n = 127) and a poor prognosis group (n = 44) based on discharge outcomes to evaluate prognostic value. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with septic shock. The dynamic trajectories of PCT, D-D, and LDH levels during hospitalization were also analyzed. Results On admission, levels of PCT, D-D, and LDH were significantly higher in the septic shock group than in the non-shock sepsis group (all p < 0.01). In the multivariable model, elevated levels of PCT (OR = 1.015, 95% CI: 1.002-1.028), D-D (OR = 1.087, 95% CI: 1.010-1.170) and LDH (OR = 1.265, 95% CI: 1.016-1.576) were independently associated with a increased likelihood of septic shock. Patients with a poor prognosis exhibited persistently elevated levels of all three biomarkers throughout hospitalization, whereas these levels decreased significantly in the improved group. Conclusion PCT, D-D, and LDH are valuable biomarkers for stratifying disease severity and predicting clinical outcomes in patients with sepsis. Specifically, admission levels of PCT, D-D, and LDH were independently associated with the development of septic shock, and their dynamic changes provided significant prognostic information.
Summary
Keywords
d-dimer, Lactate dehydrogenase, PCT, Sepsis, septic shock
Received
19 December 2025
Accepted
12 February 2026
Copyright
© 2026 Ge, Song, Hongmei, Wu and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Zhen Ren
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