Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

Background The usefulness of procalcitonin (PCT) and C-reactive protein (CRP) as individual biomarkers, and in combination, for the identification of infections in a critically ill patient cohort was evaluated retrospectively. Methods Best cut-off values for PCT and CRP for a diagnosis of sepsis in...

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Bibliographic Details
Published in:Journal of international medical research 2014-08, Vol.42 (4), p.1050-1059
Main Authors: Li, Hong-Xiang, Liu, Zhong-Min, Zhao, Shu-Jie, Zhang, Dong, Wang, Shi-Ji, Wang, Yu-Shan
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Biomarkers - blood
C-Reactive Protein - metabolism
Calcitonin - blood
Critical Illness
Female
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Sepsis - blood
Sepsis - diagnosis
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Summary:Background The usefulness of procalcitonin (PCT) and C-reactive protein (CRP) as individual biomarkers, and in combination, for the identification of infections in a critically ill patient cohort was evaluated retrospectively. Methods Best cut-off values for PCT and CRP for a diagnosis of sepsis in critically ill patients were determined using receiver operator characteristic (ROC) curve analysis. Both combined tests and individual tests were performed for PCT and CRP, with positive and negative results recorded, and accuracy evaluated using odds ratios (OR). Results In the 55 critically ill patients studied, the best cut-off value for PCT for a diagnosis of sepsis was 1.1 ng/ml (sensitivity, specificity and negative predictive values [NPV] were 82%, 68% and 71%, respectively). In addition, the best cut-off value for CRP was 50.7 mg/l ( sensitivity, specificity and NPV of 90%, 68% and 83%, respectively). Measuring PCT and CRP in combination provided a sensitivity of 79%, a specificity of 86%, and a positive predictive value (PPV) of 90%. Diagnostic OR for the combination of biomarkers versus CRP alone (19 and 18, respectively) were greater than that for PCT (9). Conclusion For critically ill patients, CRP and CRP in combination with PCT were found to be suitable biomarkers for diagnosing sepsis, based on their NPV and PPV.
ISSN:0300-0605
1473-2300
DOI:10.1177/0300060514528483