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Observational Study
. 2017 Aug 1;17(1):173.
doi: 10.1186/s12877-017-0566-5.

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

Hongmin Zhang  1 , Xiaoting Wang  1 , Qing Zhang  1 , Ying Xia  1 , Dawei Liu  2
Affiliations
Observational Study

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

Hongmin Zhang et al. BMC Geriatr. .

Abstract

Background: Although 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.

Methods: This 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.

Results: A 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.

Conclusion: For the oldest old patients, hs-CRP is not inferior to PCT in the diagnosis of sepsis and septic shock.

Keywords: High-sensitivity C-reactive protein; Oldest old; Procalcitonin; Sepsis; Septic shock.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the ethics committee of Peking Union Medical College Hospital (Approval Number: JS1300). Written informed consent was obtained from all patients or the next of kin.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diagnostic values of CRP, PCT, WBC for sepsis/SS, estimated by receiver operating curve (ROC) analysis. CRP area 0.825 (95% CI 0.73-0.92), P < 0.001; PCT area 0.819 (95% CI 0.71-0.92), P < 0.001; WBC area 0.606 (95% CI 0.46-0.75), P = 0.170. sepsis/SS: sepsis/septic shock
Fig. 2
Fig. 2
Diagnostic values for septic shock of hs-CRP, PCT, WBC, estimated by receiver operating curve (ROC) analysis. hs-CRP area 0.751 (95% CI 0.62-0.88), P = 0.002; PCT area 0.719 (95% CI 0.57-0.86), P = 0.007; WBC area 0.606 (95% CI 0.45-0.77), P = 0.165
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