Diagnostic utility of serum procalcitonin as a biomarker of sepsis and infection in post-operative patients at tertiary care centre

Abstract

Background: Procalcitonin (PCT), the precursor peptide of calcitonin, a hormone involved in calcium homeostasis, is present in normal subjects in extremely low serum levels (0.1 to 0.5 ng/ml). In response to bacterial infectious stimulation serum procalcitonin rises substantially and its role in inflammatory response includes chemotactic function modulation of inducible nitric oxide synthase and induction of cytokines, among other. The objective of this study to assess serum procalcitonin as a biomarker of sepsis and infection in post op patients.Methods: The present descriptive observational study was conducted at Department of Surgery, Aarupadai Veedu Medical College and Hospital, Puducherry from September 2018 to June 2020. Total 48 patients who had undergone surgery and presented with post-surgical sepsis were included. Data entered in MS excel sheet and analysed by using SPSS 24.0 version IBM USA.Results: Out of 48 cases, majority of cases i.e. 18 (37.5%) were from 36-50 years age group followed by 11 (22.9%) from 51-60 years age group. Prevalence of sepsis was 20.8%, septic shock 25%, severe sepsis 33.3% and SIRS 14.6%. Procalcitonin (PCT) assay shows positive in 47 (97.9%) cases. E. coli were isolated from 5 (45.5%) cases with PCT 2-10 as compared to 6 (16.7%) cases with PCT >10.Conclusions: PCT shares remarkable promise as a marker of sepsis and can be used as a routine lab parameter. It was also found to be an accurate diagnostic parameter for differentiating various stages of sepsis and predicting the outcome.