Open AccessMeasuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients
Author(s) -
Hongxiang Li,
Zhongmin Liu,
Shujie Zhao,
Dong Zhang,
Shiji Wang,
Yushan Wang
Publication year - 2014
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/0300060514528483
Subject(s) - procalcitonin , medicine , sepsis , critically ill , c reactive protein , receiver operating characteristic , gastroenterology , diagnostic odds ratio , predictive value , predictive value of tests , inflammation
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.