Sepsis Biomarkers: CRP, Procalcitonin, and Presepsin-Diagnostic and Prognostic Significance in Sepsis

脓毒症生物标志物:C反应蛋白、降钙素原和降钙素原——在脓毒症诊断和预后中的意义

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Abstract

BACKGROUND: Sepsis is undeniably a serious worldwide health threat, causing millions of deaths each year and a real diagnostic challenge to the clinicians. The conventional standard culture methods are often negative and time-consuming; therefore, alternatively specific and easily measurable biomarkers could help in predicting the diagnosis and prognosis of sepsis, as well as monitor the response to the treatments. This study will compare the role of the three markers procalcitonin (PCT), C-reactive protein (CRP), and presepsin in the diagnosis of sepsis in suspected patients admitted to a tertiary care hospital in eastern India. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted from April 2021 to March 2022. Blood samples were collected from the patients admitted in various intensive care units with evidence of sepsis and the biomarkers were estimated. RESULTS: Presepsin was found to be the best among the three biomarkers with sensitivity 89.1% and specificity 88.9%, followed by PCT with sensitivity 82.7% and specificity 80%, and then CRP with sensitivity 74.5% and specificity 75.6%. The diagnostic accuracy of presepsin was also found to be maximum as its area under the receiver-operating characteristic (ROC) curve was highest (0.858) followed by PCT whose area under the ROC curve was 0.793, and then CRP with area under the ROC curve 0.741. CONCLUSION: Based on the result of the present study, biomarkers were found to be quick, easy and effective test for diagnosing sepsis, and presepsin proved to be the most promising marker for diagnosis of sepsis as compared to PCT or CRP.

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