Usefulness of procalcitonin and some inflammatory parameters in septic patients

OBJECTIVE: To evaluate the efficacy of procalcitonin PCT to identify critically ill patients with sepsis in comparison with leukocyte count, body temperature, C-reactive protein CRP, erythrocyte sedimentation rate ESR, and interleukin-6 IL-6.

METHODS: We performed our prospective observational study in 75 patients admitted with acute systemic inflammatory response and suspected infection. The final diagnosis was systemic inflammatory response syndrome SIRS in 38 patients, sepsis in 22, severe sepsis in 10, and suspected viral sepsis in 5. Blood samples were taken on the first day of hospitalization in Al Mwasaa Hospital, Damascus, Syrian Arab Republic, from July 2006 to January 2007. We estimated the relevance of the different parameters by using the t-test, Pearson's correlation coefficient, and area under the receiver operating characteristic curves.

RESULTS: Mean PCT concentrations on admission were 0.37 ng/ml for SIRS n=38, 3.31ng/ml for sepsis n=22, 40.2 ng/ml for severe sepsis n=10, and significant differences existed in plasma PCT levels among the 3 groups. The PCT was the only distinguisher between sepsis and non-infectious SIRS, whereas it exhibited the best discriminative power between sepsis and severe sepsis with an area under the curve AUC of 0.966 followed by IL-6 with an AUC of 0.836. The PCT also do not correlate with any of the studied parameters within the SIRS group and the sepsis group.

CONCLUSION: Assessing PCT levels is a more reliable way to indicate sepsis in newly admitted patients with systemic inflammations compared with conventional inflammatory parameters and IL-6.