Role of C-reactive Protein and Procalcitonin in Early Diagnostic Accuracy and Their Prognostic Significance in Sepsis.

Autor:	Daud M; General Surgery, Lady Reading Hospital, Peshawar, PAK., Khan MB; Emergency Medicine, Bacha Khan Medical Complex, Peshawar, PAK., Qudrat QU; Medicine, Naseer Teaching Hospital, Peshawar, PAK., Ullah I; Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK., Khan S; Internal Medicine, District Head Quarter Teaching Hospital/GMC, Dera Ismail Khan, PAK., Khan MZ; Internal Medicine, Lady Reading Hospital, Peshawar, PAK., Yousuf I; Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK., Ahmad F; Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 27; Vol. 16 (9), pp. e70358. Date of Electronic Publication: 2024 Sep 27 (Print Publication: 2024).
DOI:	10.7759/cureus.70358
Abstrakt:	Introduction: Sepsis is a serious condition that often results in high fatality rates, particularly in intensive care units (ICUs). Its nonspecific clinical characteristics makes early diagnosis and therapy difficult, despite how critical they are. The use of biomarkers like procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis and prognosis of sepsis has demonstrated encouraging results. In contrast to PCT, which is highly selective for bacterial infections, CRP is an acute-phase protein that reflects systemic inflammation. Objective: This study aimed to assess the diagnostic accuracy and prognostic significance of CRP and PCT in early sepsis detection and outcome prediction. Methodology: This study was a retrospective cohort study that involved 90 patients in the ICU who met the criteria for sepsis-3. CRP and PCT levels, clinical data, and outcomes were obtained from electronic medical records. The diagnostic accuracy was tested using receiver operating characteristic (ROC) curves, while the prognostic relevance was analyzed by Kaplan-Meier survival analysis and Cox proportional hazards regression. Results: The mean CRP level was 102.3 mg/L and PCT level was 5.4 ng/mL. ROC analysis revealed an area under the curve (AUC) of 0.78 for CRP and 0.82 for PCT, indicating better diagnostic performance for PCT. High levels of CRP and PCT were associated with poorer survival, with median survival times of 18 and 15 days, respectively, for high-level groups. Cox regression identified CRP and PCT as significant predictors of mortality, with hazard ratios of 1.50 and 1.68, respectively. Conclusion: Both CRP and PCT are valuable biomarkers for diagnosing and prognosticating sepsis. PCT, with its higher specificity for bacterial infections, demonstrates superior diagnostic accuracy compared to CRP. Elevated levels of both biomarkers are associated with increased mortality risk, highlighting their potential role in early sepsis management and outcome prediction. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board (IRB) of Lady Reading Hospital-MTI issued approval 948/LRH/MTI. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Daud et al.)
Databáze:	MEDLINE
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