Objectives: To evaluate predictability of at ICU-admission levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6 and co-peptin (Cp) for outcome of patients underwent major surgical resections, admitted to surgical ICU and developed sepsis during ICU stay.
Patients & Methods: 192 patients developed mild-moderate and 63 patients developed severe sepsis 24-hr after ICU admission. On appearance of early clinical sepsis manifestations, blood samples were obtained for ELISA estimation of studied parameters. Study outcome was defined as the 28-day mortality rate (28-MR) and the best predictor for it.
Results: 28-MR was 22% and was significantly higher among severe sepsis patients. Severe sepsis patients and non-survivors were significantly older, had higher APACHE II and SOFA scores and serum levels of Cp, IL-6, PCT and CRP than patients had mild-moderate sepsis and survivors, respectively. High serum Cp level was the highly significant independent predictor for both sepsis severity and mortality, while serum PCT was significant predictor for sepsis severity. Serum Cp levels at cutoff points of ≥55.2ng/ml and ≥94.6ng/ml could predict progressively increasing hazard of development of severe sepsis and mortality, respectively.
Conclusion: Elevated serum Cp could fulfill the requirements for ideal early biomarker for diagnosis and prognosis of sepsis patients especially at the assumed cutoff points. Estimation of serum Cp and PCT in conjunction with clinical scoring could complementary act to approach highest diagnostic and prognostic yield. |
