PROCALCITONIN VS C-REACTIVE PROTEIN: COMPARISON AS MARKERS OF SEVERITY IN SEPSIS- A HOSPITAL BASED OBSERVATIONAL STUDY FROM NORTH EAST INDIA.

Abstract

BACKGROUND: Sepsis is a life-threatening organ dysfunction caused by the dysregulation of a host's response to infections (1) which is further complicated by an altered metabolic state.Both CRP and Procalcitonin are accepted sepsis markers. But there is still some debate regarding the correlation between their serum concentrations and sepsis severity. MATERIALS AND METHODS A prospective observational study was carried out in patients >18 years with sepsis and meeting the inclusion and exclusion criteria for a period of 6 months from 1st September 2021 to 28th February,2022.The severity of sepsis related organ dysfunction was assessed by the SOFA score on day 1.Patients were categorized into 4 groups according to SOFA score as group 1 (0-6),group 2 (7-12),group 3 (13-18) and group 4(19-24). Serum PCT and CRP concentrations were measured on day 1 RESULTS A total of 50 patients presenting with sepsis were studied. The mean serum PCT concentration(ng/ml) in 4 SOFA groups was 7.61,28.47,40.16,85.09(p value<0.001) respectively. The mean CRP concentration (mg/ml) in 4 SOFA groups was 157.63,152.85,144.24,64.66 respectively (p value 0.13). Mean SOFA score was higher among patients who died (11.33±5.66) than those who survived (6.71±3.57) and the difference is statistically significant(p<0.001).The mean PCT (ng/ml) and CRP (mg/l) concentration in those who survived were 17.88 and 149.30 respectively and in those who died were 35.28(p value<0.001) and 160.46 (p value 0.167) respectively. The linear correlation between PCT plasma concentrations and the four categories was much stronger than in the case of CRP (Spearman's Rho,0.483 vs -0.197;p<0.001) CONCLUSION SOFA score and serum PCT concentration show significant correlation with respect to severity of organ dysfunction and outcome in sepsis patients compared to serum CRP concentration