Serum Procalcitonic (PCT) Versus Serum C - Reactive Protein (CRP) for Severity of Organ Dysfunction in Sepsis
DOI:
https://doi.org/10.48165/fhm1jd03Keywords:
SIRS (Systemic Inflammatory Response Syndrome), SOFA (Sequential Organ Failure Assessment),, Sepsis, C - reactive protein (CRP), Procalcitonin (PCT)Abstract
Background: Intensive care units (ICUs), despite advances in critical care nursing, have frequent issues with early diagnosis and adequate treatment. Recently discovered world-class procalcitonin (PCT), a revolutionary laboratory marker, has been shown to be useful in this regard. The objective is to Comparison of concentrations of serum procalcitonin (PCT) and c-reactive protein (CRP) with a comparable level of organ malfunction during sepsis and evaluation of the interaction between serum PCT and CRP concentrations with different organ malfunction occurrence in sepsis. Design: It is a Hospital-Based Prospective study. Participants and Setting: Fifty people were admitted to the intensive care unit of Gandhi Medical College. Subjects and Methods: The extent of sepsis-related organ impairment was evaluated with the sequential organ failure assessment (SOFA) on day 1. Patients were identified by category 1(0-6), category 2(7-12), group 3(13-18), and group 4(19-24) in 4 separate classes with varying organ impairment seriousness of sepsis. Serum PCT and CRP concentrations have been measured. Results: The majority of the patients belonged to the age groups of 60-69 years (30%) and 50-59 years (22%) Majority of the patients belonged to the Sofa group 1 around 42% followed by sofa group 2 with 38%, sofa group 3 with 16% and the least belonged to the sofa group 4 with 4%. The mean PCT and CRP concentration in those who survived was 14.73 ng/ml and 149.916mg/L respectively and in those who died were 45.76 ng/ml (p-value <0.001) and 183.584 mg/L (p-value 0.172) respectively. The linear correlation between PCT plasma concentrations and the four groups was significantly stronger than with CRP. Conclusion: In SOFA and serum PCT, The level of organ dysfunction and complications in sepsis patients is closely related to serum CRP levels.
References
1. American College of Chest Physicians/Society of Critical Care Medicine Consensus Definition for sepsis and organ failure and guidelines for the innovative therapies in sepsis. Crit Care Med. 1992;20(6):864–874.
2. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP. The Natural History of the Systemic Inflammatory Response Syndrome (SIRS). JAMA. 1995;273(2):117– 123. Available from: https://dx.doi.org/10.1001/jama.1995. 03520260039030.
3. Bone RC, Fisher CJ, Clemmer TP. Sepsis syndrome: A valid clinical entity. Crit Care Med. 1989;17(5):389–393. 4. Vincent JL, Ferreira F, Moreno R. Scoring Systems for Assessing Organ Dysfunction and Survival. Crit Care Clin. 2000;16(2):353–366. Available from: https://dx.doi.org/10. 1016/s0749-0704(05)70114-7.
5. Oberhofer M, Bögel D, Meier-Hellmann A. Procalcitonin is higher in non- survivors during the clinical course of sepsis, severe sepsis and septic shock. Intensive Care Med. 1996;22:245–245.
6. Zeni F, Viallon A, Assicot M. Procalcitonin serum concentra tions and severity of sepsis. Clin Intense Care. 1994;5(2):89– 98.
7. Al-Nawas B, Krammer I, Shah PM. Procalcitonin in the diagnosis of severe infections. Eur J Med Res. 1996;1(7):331– 333.
8. Gramm HJ, Dollinger P, Beier W. Procalcitonin - einneuer Marker der inflammatorischenwirtsantwort. Longitudinalstudi enbeiPatientenmit sepsis und Peritonitis. ChirGastroenterol. 1995;11(2):51–54. Available from: https://doi.org/10.1159/ 000189907.
9. de Werra I, Jaccard C, Corradin SB, Chiolero R, Yersin B, Gallati H, et al. Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations. Crit Care Med. 1997;25(4):607–613. Available from: https://dx.doi. org/10.1097/00003246-199704000-00009.
10. Castelli GP, Pognani C, Meisner M, Stuani A, Bellomi D, Sgarbi L. Procalcitonin and C- reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction. Critical Care. 2004;8(4):234–242.