Study of serum procalcitonin in patients with sepsis, septic shock and systemic inflammatory response syndrome (SIRS)

Background: Sepsis is a complex syndrome caused by an uncontrolled systemic inflammatory response of infectious origin characterized by dysfunction or failure of one or more organs and even death. Procalcitonin (PCT) has been one of the promising markers in bacterial sepsis. Aim: This study was done to evaluate the diagnostic and prognostic value of PCT in systemic inflammatory response syndrome (SIRS), sepsis, and septic shock, and to assess its relation with sequential organ failure assessment (SOFA) Score and serum lactate. Materials and Methods: This is a prospective observational study carried out in our institute between May 2012 and September 2013. Patients with suspicion of sepsis and SIRS were included. PCT, SOFA Score, and serum lactate were assessed at admission or within 12 hours and analyzed. Results: A total of 114 patients with SIRS ( n = 14), sepsis ( n = 63), and septic shock ( n = 29) were included. Urinary tract and respiratory tract infections were the common sources of sepsis in 28.1 and 26.3% of the patients, respectively. The PCT levels were elevated in 83 patients. The mean values of serum PCT in SIRS, sepsis, and septic shock were (in ng/mL) 0.36, 6.81, 26.7, respectively. The mean values of SOFA Score in SIRS, sepsis, and septic shock were 3.4, 6.1, and 12.2, respectively. The mean values of serum lactate of SIRS, sepsis, and severe sepsis were (in mmol/L) 1.6, 2.3, and 3.9, respectively. Conclusion: Serum PCT was 82.6% sensitive, 71.4% specific, and had a positive predictive value of 95.0% in diagnosing sepsis and showed no association with SIRS. It was positively associated with high mortality and higher SOFA levels.