Diagnostic value of procalcitonin and other related inflammatory markers for severe sepsis and septic shock: A single tertiary center experience

Abstract

Background/objective: Several inflammatory biomarkers of infection including procalcitonin (PCT) and C – reactive protein (CRP) have been shown to be useful in diagnosis of infection in different clinical settings. The purpose of this study was to determine the diagnostic value of serum PCT, CRP and White Blood Cells (WBC) as markers of sepsis in critically ill patients in Qatar. Materials and methods: The PCT levels and other related inflammatory markers (CRP and WBC) were measured in 137 adult patients with a suspected diagnosis of sepsis and admitted to Internal Medicine inpatient service (i.e., Medical Wards and Medical Intensive Care Unit) at Hamad General Hospital, Hamad Medical Corporation-Qatar during the period from January 2011 to December 2013. Results: The serum PCT was measured by chemoluminiscence immunoassay and the results were compared with other inflammatory markers between the patients with and without proven sepsis. A significantly higher PCT level was observed among patients with severe sepsis and septic shock compared to those without sepsis (19.34 ± 50 and 25.91 ± 61.3 vs. 4.72 ± 10, respectively; (p = 0.011). No significant differences were found in CRP and WBC between these groups. Non-survivors of both septic and non-septic groups had a mean PCT level of 22.48 ± 8.26 significantly higher than that measured in survivors of both groups (p = 0.01), a difference not evident in other inflammatory parameters. Conclusion: PCT is a highly efficient inflammatory laboratory parameter for the diagnosis of severe sepsis and septic shock but WBC and CRP levels were of little value. PCT value assists in diagnosis of septic shock hence supporting appropriate disposition of patients. Levels of PCT also have prognostic implications with regards to mortality suggesting intensification of antibiotic therapy and supportive measures including appropriate family counseling.