Procalcitonin and C-Reactive Protein as a Predictor of Organ Dysfunction and Outcome of Sepsis and Septic Shock Patients in Intensive Care Unit

Abstract

BACKGROUND & OBJECTIVE: Sepsis is a potentially life-threatening disorder in ICU. The worst complication is organ dysfunction and mortality. Procalcitonin (PCT) and C-Reactive Protein (CRP) had been proposed as biomarker and predictor for diagnosis, prognosis, and patient deterioration in sepsis and septic shock patients. To know whether PCT and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients in ICU.MATERIALS & METHODS: Data were cohort retrospectively analyzed in 35 sepsis (45.5%) and 42 septic shock patients (54.5%) admitted to ICU Dr. Wahidin Sudirohusodo General Hospital (January 2014 – December 2015). Data were analyzed using Chi-Square test, Pearson Correlation, and Spearman-Rho Correlation test.RESULTS: Total of 77 patients met the inclusion criteria. Cut-off point in predicting organ dysfunction in sepsis and septic shock was significantly higher in PCT (45.7ng/mL) with 76.6% sensitivity and 70.0% specificity, while CRP was 145.75 mg/mL with 70.2% sensitivity and 56.7% specificity. There was a positive correlation of PCT (0.492 [p=0.000]) and CRP (0.336 [p=0.003]) to organ dysfunction reflected on SOFA score using the Pearson Correlation test (p<0.01 statistically significant). Based on Spearman-Rho Correlation test, correlation of PCT (0.191 [p=0.097]) and CRP (0.110 [p=0.340]) to outcome in day-7 was positive but not statistically significant (p≥0.01). While in day-28, there was positive correlation 0.553 (p=0.001) for PCT, 0.460 (p=0.006) for CRP, and statistically significant (p<0.01).CONCLUSIONS: Procalcitonin and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients.