Role of Procalcitonin, C-reactive Protein and Total Leucocyte Count in Suspected Cases of Sepsis

Abstract

Background: Sepsis is a life-threatening infection, responsible for tremendous morbidity, mortality and healthcare expenditure worldwide. Sepsis is characterized by non-specific symptoms and clinical diagnosis remains difficult. C Reactive protein (CRP) and procalcitonin (PCT) are now days used as surrogate markers of sepsis. Aim: To determine PCT levels in patients with suspected sepsis and its correlation with CRP and total leucocyte count (TLC). Material & Methods: The retrospective study was conducted in tertiary care hospital in India. Adults patients (> 18 years) admitted to Intensive care unit in the hospital during study period, fulfilling the ACCP criterion for the diagnosis of sepsis were included in the study. Data was collected using laboratory software maintaining confidentiality. Results: The study comprised of 190 patients. Patients were divided into four groups based on PCT values and severity of sepsis. Out of 190 patients, PCT was positive in 135 patients. The CRP and TLC levels were distributed into the four PCT groups and their correlation with PCT was studied. For PCT values between 2-10ng/ml, >10ng/ml CRP showed statistically significant correlation with p value <0.05, whereas correlation of TLC with PCT was poor. Conclusion Procalcitonin along with CRP is a better diagnostic tool for sepsis but their correlation in context to TLC was poor. Due to lack of an ideal isolated marker, our study mandates multidisciplinary approach for diagnosis of sepsis. Keywords: Sepsis, Procalcitonin, C reactive protein, Total leucocyte count, Culture