The prognostic value of procalcitonin

Abstract

The search continues for a highly sensitive marker to diagnose sepsis early and predict severity and outcome. Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to an infection, according to the Third International Consensus Definitions for Sepsis and Septic Shock. Traditional microbiological tests for diagnosing infection are highly specific and easily available in routine practice; however, their sensitivity is only 25-42%, and a negative blood culture result does not guarantee the absence of bacteremia [2,3]. In addition, 48 h is needed to obtain the final results, and there is no opportunity to evaluate the contribution of nonculturable microorganisms to the infectious and inflammatory process, which limits the diagnostic ability of the method [2,3]. Clinical and laboratory scales are available to evaluate the severity of multiple organ dysfunction syndrome, such as the Sequential Organ Failure Assessment (SOFA) and the Logistic Organ Dysfunction System. However, scoring only confirms the presence of already developed multiple organ dysfunction. Clinical practice requires markers that predict a high risk of multiple organ dysfunction in patients with an infection. In recent years, more than 178 biomarkers have been studied and reported in 3,370 articles on the early diagnosis of sepsis. The present study focused on procalcitonin (PCT), Creactive protein (CRP), and cholesterol as the most accessible and cost-effective of these markers. The objective of this study was to establish the prognostic value of PCT, CRP, and cholesterol levels for mortality in patients with an infection and multiple organ dysfunction.