Efficiency diagnostic and advantages of procalcitonin and C-reactive protein in the early diagnosis of sepsis

Introduction

The goal of our study is to assess the diagnostic profitability of procalcitonin (PCT) in septic shock and another biomarker as C-reactive protein (CRP).

Methods

Case-control study. During 2009 we proceeded to select the sample: 54 patients (ICU) and 61 controls. PCT and CRP were set in the first 24 hours besides the diagnosis and other analytical (glucose, lactate, leukocytes, platelets, white blood cells, LIC cells and ALY cells) and clinical parameters. There were realized diagnostic output curves (ROC), area under the curve (AUC), confidence interval (95%), cut-off and the comparison between AUC.

Results

Fifty-four septic patients were assessed, 66% were males; mean age, 63 years. Eighty-eight percent was diagnosed as septic shock and 11% severe sepsis. Seventy-six percent were medical patients. Positive blood cultures in 42.5%. Sepsis origin: respiratory 46%, neurological 5%, digestive 37% and urinary 3%. Average SOFA score was 10.4.

Conclusions

PCT and CRP have the same efficiency in early sepsis diagnosis. The PCT and CRP efficiency diagnostic together is significant but small. We suggest using both with the doubt of sepsis.

Table 1 Output curve results: PCT/CRP, sensitivity, specificity

Figure 1

Comparison between AUC not significantly different for PCT and CRP ( P = 0.445).