Comparative Evaluation of Procalcitonin and Interleukin-6 as Diagnostic and Prognostic Biomarkers for Sepsis
Published: October 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/37394.12185
Padmanaban Kandaswamy, Hemlata, Gyan Prakash Singh, Mohammad Kaleem Ahmad
1. Resident, Department of Anaesthesiology and Critical Care, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India.
2. Assistant Professor, Department of Anaesthesiology and Critical Care, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India.
3. Professor, Department of Anaesthesiology and Critical Care, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India.
4. Assistant Professor, Department of Biochemistry, King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India.
Correspondence
Dr. Hemlata,
Type IV/3, SGPGI Campus, Lucknow-226014, Uttar Pradesh, India.
E-mail: hema2211@yahoo.co.in
Introduction:Diagnosis of sepsis is based on host’s systemic inflammatory response to infection including life-threatening organ dysfunction. Various biomarkers are available for diagnosis and prognostication of patients with sepsis, Procalcitonin (PCT) and interleukin-6 (IL-6) being most reliable.
Aim: To compare PCT and IL-6 as diagnostic and prognostic biomarkers of sepsis in patients admitted with Systemic Inflammatory Response Syndrome (SIRS).
Materials and Methods: After taking Ethical Committee Approval, a total of 51 patients aged 15-65 years admitted in ICU with SIRS were identified. Patients with baseline Sequential Organ Failure Assessment (SOFA) score of 0 and 1 were categorised into non-infectious group and SOFA of greater than 2 into infectious group. Procalcitonin and IL-6 were measured on day 1 and 3 using enzyme-linked immunosorbent assay. Collected data were analysed using SPSS software version 22.0. Parametric data were compared using Student’s t-test. Other tests used were Mann-Whitney U test, Pearson’s chi-square test, Fisher’s-exact test, Friedman’s test, ANOVA.
Results: PCT (day 1 and 3) was significantly higher in the infectious group than non-infectious group (p<0.001) and day 1 PCT was found to be better in diagnosing sepsis with Area Under the Curve (AUC) of 0.90 (95% CI, 0.789-1.000) (p=0.001). Unlike day 1 PCT, day 3 PCT was statistically significant in predicting mortality with AUC of 0.982 (95% CI, 0.956-1.000) (p<0.005). IL-6 was found to be better in predicting mortality with day 1 AUC of 0.987 (95% CI, 0.966-1.000) (p<0.005) and day 3 AUC of 0.981 (95%CI, 0.953-1.000) (p<0.005). Multivariate analysis of mortality prediction showed day 1 IL-6 to have a better mortality prediction value (p=0.047).
Conclusion: PCT on day 1 was found to be better in identifying sepsis and day 1 IL-6 and day 3 PCT in predicting mortality.
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