Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients

BMC Geriatrics

Research Article

Ying Xia¹  Hongmin Zhang¹  Dawei Liu¹  Xiaoting Wang¹  Qing Zhang¹ 

[1] Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1# Shuai Fu Yuan, Dong Cheng District, 100730, Beijing, China;

关键词: Procalcitonin;    High-sensitivity C-reactive protein;    Sepsis;    Septic shock;    Oldest old;   

DOI  :  10.1186/s12877-017-0566-5

 received in 2017-03-31, accepted in 2017-07-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough the role of serum procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of sepsis and septic shock is well studied, it has not been investigated among oldest old patients. The aim of our study is to determine the role of PCT and hs-CRP in the assessment of sepsis and septic shock in this specific group of patients in the ICU.MethodsThis is a prospective observational study. Patients >85 years of age admitted to the ICU from May 1st, 2016 to February 1st, 2017 were evaluated. Patients were divided into a sepsis and septic shock group(sepsis/SS) and a non-sepsis group. Serum levels of PCT, hs-CRP and the WBC were measured within 12 h of admission.ResultsA total of 70 patients aged 85 years and older were enrolled in this study. Fifty patients were labelled as sepsis/SS and the other 20 were labelled non-sepsis. A ROC analysis showed that the area under the curves (AUC) of hs-CRP and PCT for the discrimination of sepsis/SS patients were 0.825 (95% confidence interval[CI]: 0.73-0.92; P < 0.001) and 0.819 (95%CI:0.72-0.92; p < 0.001), respectively. In a subgroup analysis of the sepsis/SS group, 27 patients had sepsis, while the other 23 patients had septic shock. The ROC analysis showed that the AUCs of hs-CRP and PCT for the discrimination of septic shock patients from sepsis patients were 0.751 (95% CI: 0.62-0.88; P = 0.002) and 0.719 (95% CI:0.57-0.86; p = 0.007), respectively.ConclusionFor the oldest old patients, hs-CRP is not inferior to PCT in the diagnosis of sepsis and septic shock.

【 授权许可】

CC BY   
© The Author(s). 2017