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. 2024 Dec;28(12):1130-1138.
doi: 10.5005/jp-journals-10071-24855. Epub 2024 Nov 30.

Study of the Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in ICU Patients with Sepsis: A Prospective Observational Study

Eman M Abdellatif  1 , Emad H Hamouda  2
Affiliations

Study of the Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in ICU Patients with Sepsis: A Prospective Observational Study

Eman M Abdellatif et al. Indian J Crit Care Med. 2024 Dec.

Abstract

Background: Prediction of prognosis in sepsis is an essential research area aiming to improve disease outcomes. In this study, we investigated the role of the C-reactive protein (CRP)/procalcitonin (PCT) ratio as a prognostic tool in sepsis patients.

Materials and methods: This prospective observational study was conducted at the intensive care unit (ICU) of Alexandria Main University Hospital in the period from January to June 2024. One hundred and seventy patients with a diagnosis of sepsis were enrolled. Sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEII) score and CRP/PCT ratio were calculated on admission (day 1), and as a follow-up on day 3. Patients were subsequently divided into survivor and non-survivor groups, and the data were compared.

Results: The CRP/PCT ratio was significantly lower, on admission and on follow-up, in non-survivor patients than in survivor patients. The ratio median (minimum-maximum) in non-survivors was 4.82 (1.51-23.28) vs 11.23 (1.85-136.7) in survivors on admission, and it was 7.37 (2.27-26.36) in non-survivors vs 11.37 (2.78-110.9) in survivors on day 3. The ratio was significantly lower in patients with septic shock than in non-septic shock patients. The ratio had a significant negative correlation with both SOFA and APACHEII scores. The receiver operating characteristic (ROC) curve showed high accuracy of the day 1 CRP/PCT ratio to predict mortality [area under curve (AUC = 0.835)], which is comparable to the day 1 SOFA score (AUC = 0.878) and higher than the day 1 PCT and day 1 APACHE scores.

Conclusion: Our results suggest a potential role for the CRP/PCT ratio, on admission and on follow-up, as a marker for predicting prognosis in sepsis patients, where low ratio values can predict poor disease outcome.

How to cite this article: Abdellatif EM, Hamouda EH. Study of the Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in ICU Patients with Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2024;28(12):1130-1138.

Keywords: C-reactive protein/PCT ratio; Intensive care unit; Procalcitonin; Prognosis; SOFA score; Sepsis.

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Conflict of interest statement

Source of support: Nil Conflict of interest: NoneConflict of interest: None

Figures

Fig. 1
Fig. 1
Flow diagram of the study subjects
Fig. 2
Fig. 2
Comparison between the two studied groups according to CRP/PCT ratio
Figs 3A and B
Figs 3A and B
Correlation between CRP/PCT ratio and SOFA score in all study subjects, (A) On admission; (B) On day 3 follow-up
Figs 4A and B
Figs 4A and B
Correlation between CRP/PCT ratio and APACHEII score in all study subjects, (A) On admission; (B) On day 3 follow-up
Fig. 5
Fig. 5
Relation between CRP/PCT ratio on admission and presence of septic shock
Figs 6A and B
Figs 6A and B
ROC curve for different study markers, on admission, to predict 30-day hospital mortality, (A) ROC curves for SOFA score, CRP/PCT ratio, PCT, and combined SOFA score with CRP/PCT ratio; (B) ROC curves for APACHEII score, and CRP
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