Diagnostic value of procalcitonin levels as an early indicator of sepsis

Researchers and clinicians have been investigating and implementing various methods of early diagnosis for sepsis before documentation of infection. The aim of this study was to outline the efficiency of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) in determining the early diagnosis of sepsis in the emergency department. Between January 1999 and September 2000, 34 patients with signs of systemic inflammatory response syndrome (SIRS) were enrolled in the study. The patients were divided into 2 groups according to nonsuspected sepsis and suspected sepsis clinically. Admission PCT was significantly higher in suspected sepsis group (median 68.7 mug/L; lower [L] = 15.24 mug/L, upper [U] = 120.54 mug/L) compared with the unsuspected sepsis group (.23 mug/L; L = .10 mug/L, U = .44 mug/L). PCT values were compared with WBC and CRP levels. Predictive accuracy for sepsis expressed as area under the receiver operating characteristic (ROC) curve was .88 for PCT, .44 for WBC, and .34 for CRP. PCT can probably be used as a predictive marker in bacterial infections in emergency departments. (Am J Emerg Med 2002;20;202-206. Copyright 2002, Elsevier Science (USA). All rights reserved.)