Procalcitonin and c-reactive protein as infection marker for systemic inflammatory response syndrome in postoperative patients

Abstract EN

Background : Sepsis is clinically defined as the systemic inflammatory response syndrome (SIRS) secondary to infection.

Manifestations of sepsis as fever, leukocytosis and tachycardia are neither specific nor sensitive for infection.

Sepsis response involves the release of a wide array of mediators which led to the suggestion of these mediators could be used as markers of infection or sepsis.

Objective: to assess the validity of procalcitonin (PCT) and C-reactive protein (CRP) as an infection monitoring parameters in discriminating between septic and non-septic postoperative patients with systemic inflammatory response syndrome (SIRS( Subject and Methods : Forty three postoperative patients with SIRS were classified into infected (n = 23) and non-infected groups (n = 20).

14 healthy individuals as control group were enrolled in the study.

PCT, CRP and complete blood picture (CBC) were assessed in postoperative patients within 24 hours of SIRS onset as well as clinical symptoms and signs of infections.

Results : PCT levels were significantly higher among infected group (mean = 61.37 ± 19.98 ng / ml) compared to control group (mean = 16.35 ± 3.97) as well as to non-infected group (mean = 21.12 ± 9.73) (p < 0.001 for each).

The cut off value of PCT was 23.12 ng / ml, with 91.5 % sensitivity and89.7 % specificity, with diagnostic accuracy 90.7 %.

A significant higher levels of CRP observed among infected group (mean = 27.39 +.

25.06) compared both to control group (mean = 3.43 + 1.02 ng / ml) and to non-infected group (mean = 4.9 ± 2.7J) (p < 0.001 for each).

Conclusion : The cut off value of CRP was 6.9 IU / ml with 86.96 % sensitivity and 85 % specificity.

PCT had a higher diagnostic accuracy than CRP for detection of infection among postoperative patients with SIRS.

Determination of serum PCT and CRP can be used as an infection marker in postoperative patients with SIRS.

Therefore, identification of infection helps to initiate appropriate therapy and consequently reducing the incidence of postoperative morbidity, hospital stay and cost.