Abstract

One of the most common cause for morbidity and mortality in patients hospitalized to the intensive care unit is bacterial sepsis. In critically ill patients, sepsis can be difficult to distinguish in the early stages from non-infectious illnesses; patients with and without sepsis also have very different outcomes from diagnosis to treatment. Objectives of the study: The study is intended to study the levels of c-reactive protein, leukocyte count and pro-calcitonin levels in patients with sepsis admitted in Medical ICU of our tertiary care hospital. Methodology: The present study prospectively included all consecutive patients presenting with systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis or septic shock on admission to the MICU of our tertiary care hospital during the study period of November 2022 to October 2023. Results and Conclusion: In the present study, a total of 240 patients were included based on inclusion and exclusion criteria. Out of which 98 (40.8%) had SIRS, 74 (30.83%) had Sepsis, 48 (20%) had severe sepsis and 20 (8.33%) had septic shock. The mean age of the patients included in the study was 32.18 ± 8.24 years, out of 240 patients 164 (68.33%) were males and 76 (31.66%) were females. The mean levels of pro-calcitonin were 9.12 ± 12.64 ng/mL, c-reactive protein were 32.46 ± 18.36 mg/L and Total leukocyte count was 14000 x106/L. 142 patients had positive blood culture reports and 98 were negative. The most common isolates were E-coli, followed by klebsiella, pseudomonas and Acinetobacter. The diagnostic value of each marker was evaluated and it is found that sensitivity for PCT, CRP and TLC were 78.42%, 86.24% and 84.62% respectively. The specificity were 74.24%, 32.64% and 31.64% respectively. The NPV(Negative Predictive value) and PPV(Positive Predictive value) were 92.24%, 78.24%, 79.98%, 48.86%, 38.64% and 39.88% respectively for PCT, CRP and LC respectively. In the present study we found that the PCT has superior diagnostic value in sepsis as compared to other biomarkers, hence this biomarker can be employed as a routine diagnostic and prognostic biomarker in sepsis patients. However, further large scale studies are recommended to evaluate the diagnostic as well as prognostic utility of PCT in ICU setting of tertiary care hospitals.

Description