Procalcitonin (PCT), C reactive protein (CRP) and its correlation with severity in early sepsis

Abstract


Fernando Rogelio Espinosa López, Abraham Emilio Reyes Jiménez, Germán Carrasco Tobon, Jesús Duarte Mote*, and Octavio Novoa Farías

Sepsis is a common cause of death, and represents a potentially life threatening disorder. Biochemical markers useful to initiate early antimicrobial treatment are being studied. Procalcitonin (PCT) and C reactive protein (CRP) have been proposed as markers for this purpose. To establish the level of PCT and CRP in early sepsis and its correlation with the APACHE II scale, levels of PCT and CRP were taken from 39 patients with sepsis criteria. They were correlated with the severity scale of APACHE II. Cultures were taken prior to antimicrobial usage to corroborate the bacterial origin in patients who were admitted to the Internal Medicine Service of the North Central Hospital of Petróleos Mexicanos. Descriptive statistics were performed (mean and standard deviation for numerical values and percentages) for nominal values. Pearson correlation and relative risk tests were performed to determine correlations. 39 patients in total; 20 with positive cultures and 19 with negative; patients with positive cultures showed PCT levels above 0.5 ng/ml; negatives below this number. The mean for CRP was 128 mg/ml. Correlation of mortality/APACHE II r = 0.707 p = 0.01; PCT/APACHE II r = 0.523 p = 0.001. For cultures: CRP/culture r = 0.575 p = 0.0001, PCT/culture r =0.448 p = 0.004. Relative risk (RR): PCT > than 2 ng/dl and cultures RR= 4. The relative risk PCT >2 mg/dl and death RR= 3.3. Cultures and CRP>128 RR= 2.4; death and CRP > 128 mg/dl RR= 2. PCT and CRP values are useful markers to determine early gravity of an infectious illness; PCT is useful to demonstrate early form of bacterial processes.

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