Reliability of Procalcitonin as a Severity Marker in Critically Ill Patients with Inflammatory Response

Abstract

Procalcitonin (PCT) is increasingly recognised as an important diagnostic parameter in clinical evaluation of the critically ill. This prospective study was designed to investigate PCT as a diagnostic marker of infection in critically ill patients with sepsis. Eighty-five adult ICU patients were studied. Four groups were defined on the basis of clinical, laboratory and bacteriologic findings as systemic inflammatory response syndrome (SIRS) (n=10), sepsis (n=16), severe sepsis (n=18) and septic shock (n=41). Data were collected including C-reactive protein (CRP), PCT levels and Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores on each ICU day. PCT levels were significantly higher in patients with severe sepsis and septic shock (19.25±43.08 and 37.15± 61.39 ng/ml) than patients with SIRS (0.73±1.37 ng/ml) (P We suggest that PCT is a more reliable marker than CRP in defining infection as a cause of systemic inflammatory response.