Comparative study between different sepsis biomarkers (procalcitonin, interleukin 6 and C reactive protein) as regard their diagnostic and prognostic values in intensive care unit (ICU) patients suffering from sepsis

Abstract

Infectious complications occur frequently in intensive care unit and have a major influence on patient outcome and hospital costs. The early identification of patients who developed infectious complications is crucial for timely and adequate treatment. Severe sepsis is still a major cause of ICU morbidity and mortality, with an incidence ranging between 20 to 52% and high mortality (42% to 80%). Septic complications in ICU consist mainly of surgical site infections (up to 40%), pulmonary infections (10%) and urinary infections (5%). Anastomotic leakage and intra-abdominal abscess are the most feared complications and are frequently diagnosed late in the postoperative period since the initial clinical manifestations are very subtle. About 30% of patients admitted to the ICU with intra-abdominal infection died, with mortality rates even higher when peritonitis arises as a complication of a previous operative procedure. The early identification of patients at risk for infection would be of clinical importance, since clinical signs are usually insensitive and do not allow an early diagnosis. Several biochemical tests are used to identify persistent inflammatory activity in postoperative patients, including CRP, PCT and interleukins. In the present study, 60 septic patients in ICU were divided into two groups, 30 patients who developed septic manifestations (Group Ι, Septic) and 30 patients who had severe septic complications and/or septic shock (Group Π, severe septic)., CRP, PCT, IL6, ABG and SOFA score parameters were measured on the day of admission day (0) and on day (3 and 7). We compared and categorized all patients according to SOFA score for sepsis as studied in the definition of inflammatory response and sepsis and severe sepsis and septic shock.