Abstract

Background and Objective: Sepsis is characterized by multiple organ dysfunction due to inflammation. It is generally credited to pathogenic infection, but there are several cases of non-infectious sepsis. Procalcitonin is a small protein that signals increased inflammation during sepsis. This study aims to characterize the prognostic value of procalcitonin in predicting sepsis severity and discriminating infectious and non-infectious sepsis.
Methods: We performed a prospective non-Interventional study, including 75 participants suffering from sepsis. The patients were grouped according to disease severity and their procalcitonin levels measured. The biochemical and microbiological outcomes were analyzed with respect to procalcitonin levels. Results were analyzed by the chi - square test, Kruskal-Wallis test, or Mann-Whitney test. Further, the receiver operating characteristic curve (ROC) was plotted for procalcitonin levels and type of infection and the area under the ROC curve was calculated.
Results: Procalcitonin was found to be correlated with sepsis severity (p=1.80E-09). A significant relationship was observed between procalcitonin levels and the presence of infection (p=0.03996). The area under the ROC curve of procalcitonin for determining presence of infection was 65.18%. At cut-off of 0.6494 (ng/mL) the sensitivity and specificity was found to be 69.81% and 63.63%. Moreover, the presence of methicillin resistant Staphylococcus aureus conferred increased procalcitonin than methicillin sensitive variety (p= 0.0098).
Conclusion: We show that procalcitonin is a predictor of sepsis severity. It can be used to predict the type of infection in patients of sepsis in a critical care setting.