Diagnostic and Prognostic Significance of Procalcitonin and CRP in Septicaemia

Author(s): Anand Mohan Verma1 , Azhar Ali Khan2

BACKGROUND Sepsis is a major cause of morbidity and mortality. Early diagnosis and treatment with adequate antimicrobial therapy are essential for successful treatment. Despite the use of available treatment modalities, mortality and morbidity in sepsis remain high. Cost of therapy and burden over the society increase as the diagnosis is delayed. The prognosis also worsens with delayed diagnosis and treatment. The study was designed to assess the levels of serum procalcitonin and CRP in patients with septicaemia and determine as to whether serum procalcitonin level and CRP levels correlate with the severity of septicaemia or not and correlate (procalcitonin, CRP and both) with survival outcome in cases of sepsis. METHODS All patients were subjected to detailed clinical examination and investigations. Patient’s clinical profile, progression of disease and outcome were recorded. Serum procalcitonin level and various other relevant factors were also measured in all the study subjects. Patients admitted at Nehru Hospital, BRD Medical College, Gorakhpur were included in the study. A total of 60 patients were included in the study. The study period was from August 2017 to December 2017. RESULTS Procalcitonin is a useful marker for severity of infection. Increased level of procalcitonin is highly specific for infection. Low procalcitonin level cannot be used safely to exclude the presence of infection. Higher level of serum procalcitonin predicts mortality better than other available parameters. High CRP levels (more than 2 times than normal value) are also associated with high mortality but somewhat is inferior in predicting the outcome. High procalcitonin level along with raised CRP, best correlates with the poor outcome. CONCLUSIONS Although sepsis is mainly a clinical diagnosis and its severity can be assessed by scores like APACHE II, serum procalcitonin is a better marker for the assessing severity of the sepsis. Serum procalcitonin can aid in early diagnosis as it appears in blood earlier than other markers. Procalcitonin and CRP together predict mortality better than other markers.