Are procalcitonin and C-reactive protein accurate prognostic markers in sepsis?

Abstract number: 1733_1241

Tsiavos V., Charitos D., Komitopoulou A., Kanavou A., Varsamis E., Komitopoulos N., Giakoymaki E.

The initial presentation of sepsis is often non specific and its severity is sometimes underestimated. Procalcitonin is the prohormone of calcitonin produced by several cell types and many organs in response to pro-inflamatory stimuli, in particular by bacterial products. High values of Procalcitonin (PCT) and C-Reactive Protein (CRP) are considered useful and reliable markers for the diagnosis of sepsis, but their association with sepsis severity is still debated.

Aim: To evaluate whether PCT and CRP serum levels could be correlated with APACHE II score in septic elderly patients.

Subjects and Methods: 48 patients, 23 females and 25 males, with sepsis of various origin, aged 74 ± 15 years, were included in this study. PCT levels (semi-quantitative immunochromatographic test, DIACHEL), high sensitivity CRP levels (DADE BEHRING) and APACHE II score were measured within 6 hours after hospital admission.

Results: PCT values were found >0.5 ng/dl in 78% of the patients. The mean value of APACHE II score in patients with PCT >2 ng/dl (cut off of severe sepsis) was compared with that of patients with PCT < 2ng/dl and no statistically significant difference was found (20.7 ± 8.2 vs 17.9 ± 8.3, respectively, student t-test, p = 0.3). Although the CRP values in septic patients were high (150 ± 107 mg/L), no correlation between CRP and APACHE score was observed (Regression analysis, p = 0.19). No significant differences were also found in the PCT and CRP levels between patients who survived and succumbed.

In conclusion, the high levels of PCT and CRP could contribute to the diagnosis of sepsis in elderly patients but might lack prognostic accuracy.