Procalcitonin: Biomarker in pediatric sepsis

Abstract

Introduction: Sepsis is a growing problem worldwide with a relatively high mortality rate. Immediate treatment is required, necessitating quick and accurate diagnosis. Taking into account the new definition of sepsis in children and evaluating the need for effective and rapid laboratory indicator, we studied the role of serum procalcitonin (PCT) as a biomarker in diagnosis and prognosis of sepsis in children. Methods:This prospective study was done in a pediatric intensive care unit (PICU) of a tertiary care centre. 149 patients with sepsis were included for the study with an age >28 days and 24 hours. PCT was measured at the time of admission. Patients were followed up throughout their hospital stay and outcome data was obtained.Results: Of the 149 patients, 93 survived while 56 died. PCT was not significantly associated with increased mortality in our study cases (p=0.346). Serum PCT values >2 ng/ml reported 52.6% sensitivity, 65.5% specificity, 55% positive predictive value and 65% negative predictive value to diagnose sepsis. Pediatric risk of mortality (PRISM) and pediatric logistics organ dysfunction (PELOD) scores were independently associated with mortality and also had a strong correlation with serum PCT values.Conclusions: High serum PCT levels has poor association with mortality in patients of sepsis. Although, PCT has strong association with current prognostic score, more multicentre studies involving higher number of patients are needed to evaluate role of PCT in sepsis.