The Role of Procalcitonin and Red Cell Distribution Width as Diagnostic and Prognostic Biomarkers in Patients with Sepsis and Septic Shock at Intensive Care Unit

Abstract

Abstract Background Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total sequential organ failure assessment (SOFA). Septic shock is a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. Biomarkers can be used in suspected sepsis for identifying or ruling out sepsis, evaluating the severity and assessing the prognosis and evaluating patients’ response to proper treatment. This study is on procalcitonin (PCT) and red cell distribution width (RDW) as diagnostic and prognostic biomarkers in patients with sepsis and septic shock. Objective This study aims to assess the feasibility of PCT and RDW as early diagnostic and prognostic biomarkers in patients with sepsis and septic shock. Methods This is a prospective observational study, in which 100 blood samples of clinically suspected sepsis and septic shock patients’ were included following a convenience sampling technique. PCT and RDW were recorded in day 0, 3, 6, 9 and 12. Results A rise in RDW and PCT levels could serve as early indicators of outcome including mortality. We found that baseline RDW cut-off point > 15.6 with sensitivity of 80.0%, specificity of 85.71% while in day 12 cut-off point > 17.3 with sensitivity of 60.0%, specificity of 100.0%. Accordingly PCT cut-off point > 4.1 with sensitivity of 80.0% and specificity of 94.29% in baseline values. While cut-off point in day 12 was > 0.7 with sensitivity of 80.0%, specificity of 97.0%. Conclusion A significant concurrence was seen between elevated serum PCT and RDW levels with severity and prognosis of sepsis. They were found to be a good predictor of sepsis and low levels rule out an infection.