Harsha Virendra Patil1, Virendra Chandrashekhar Patil2
1Department of Microbiology, Krishna Institute of Medical Sciences, Deemed to be University, Karad, Maharashtra, India.
2Department of Medicine, Krishna Institute of Medical Sciences, Deemed to be University, Karad, Maharashtra, India.
Background: The early diagnosis and appropriate therapy of sepsis is a challenge in intensive care units in spite of the advances in critical care medicine. Aim of the study: The aim is to study and compare procalcitonin (PCT) and C-reactive protein (CRP) levels in patients admitted with the diagnosis of sepsis to the critical care unit. Materials and Methods: This was a prospective observational study conducted at the teaching hospital over a period of 1 year. All patients with evidence of sepsis were enrolled for this study and were underwent relevant history, laboratory biochemical and imaging investigations including PCT and CRP levels. Results: A total of 64 patients with the diagnosis of sepsis were enrolled in this study. A total of 43 (67.19%) were male and 21 (32.81%) were female. The mean and standard deviation for the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score was 18 (±7), Sepsis-Related Organ Failure Assessment (SOFA) score was 9 (±5), papillary thyroid cancer as 19.07 (±7.02 ng/ml), and CRP was 33.5 (±15.7 mg/l). About 56.25% of patients had PCT in the range of 2–10 ng/ml, 28.13% had >10 ng/ml, and 14.06% had between 0.5 and 1.9 ng/ml. A total of 43 (67.19%) patients had a positive culture for organisms and 21 (32.81%) had sterile with no growth on culture with P < 0.001. The mean (20.74 ± 7.13). PCT levels were significantly high in Gram-negative organisms compared to (9.71 ± 0.96). Gram-positive organisms with P < 0.02. APACHE-II score, SOFA score, and CRP had a positive correlation with serum PCT levels and negative correlation with creatinine, pH, Glasgow Coma Scale and PaO2 level. Multivariate analysis revealed that the serum PCT level was better correlated with the variable of sepsis than to CRP (P < 0.01). Conclusion: The present study concludes that the PCT was statistically significantly correlated with the severity of sepsis, APACHE-II, and SOFA score than CRP. The higher level of PCT was associated with Gram-negative sepsis and mortality.
Keywords: Acute Physiology and Chronic Health Evaluation-II score, C-reactive protein, Gram-negative organism, procalcitonin, sepsis, Sepsis-Related Organ Failure Assessment score.