Usefulness of procalcitonin serum level for the discrimination of severe sepsis from sepsis: a multicenter prospective study.
Procalcitonin serum level has been recommended as a new marker of bacterial infectious diseases. The aim of this prospective, multicenter study was to determine the clinical usefulness of procalcitonin in differentiating patients with sepsis from those with severe sepsis. Eighty-two patients were enrolled: 20 without systemic inflammatory response syndrome (SIRS), 9 with SIRS, 34 with sepsis, and 19 with severe sepsis. The patients with severe sepsis had significantly higher procalcitonin levels (median, 36.1 ng/ml) than those with sepsis (median, 0.6 ng/ml). With a procalcitonin cutoff value of 2.0 ng/ml, sensitivity for the detection of severe sepsis and specificity for the detection of sepsis were 94.7% and 78.1%, respectively. A good correlation was found between the serum procalcitonin level and the Sepsis-Related Organ Failure Assessment (SOFA) score (r = 0.680), although no correlation was found between the C-reactive protein (CRP) level and the SOFA score. In conclusion, the procalcitonin serum level may be useful not only for aiding the diagnosis of sepsis but also for discriminating between sepsis and severe sepsis.
Endo
Shigeatsu
S
Critical Care and Emergency Center, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan. sendo@iwate-med.ac.jp
Aikawa
Naoki
N
Fujishima
Seitaro
S
Sekine
Isao
I
Kogawa
Kazuhiro
K
Yamamoto
Yasuhiro
Y
Kushimoto
Shigeki
S
Yukioka
Hidekazu
H
Kato
Noboru
N
Totsuka
Kyoichi
K
Kikuchi
Ken
K
Ikeda
Toshiaki
T
Ikeda
Kazumi
K
Yamada
Hiroyuki
H
Harada
Kazuaki
K
Satomura
Shinji
S
D018806:APACHE; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D004731:Endotoxins / Q000097:blood; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*; D012720:Severity of Illness Index; D047071:beta-Glucans / Q000097:blood
D015415:Biomarkers; C000606589:CALCA protein, human; D004731:Endotoxins; D006023:Glycoproteins; D015850:Interleukin-6; D011498:Protein Precursors; D047071:beta-Glucans; D002116:Calcitonin; D002097:C-Reactive Protein; C033363:beta-1,3-glucan; D015740:Calcitonin Gene-Related Peptide