Harsha Virendra Patil¹, Virendra Chandrashekhar Patil^2
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.
DOI: 10.4103/jnsbm.JNSBM_1_20

ABSTRACT

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.