Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis

Tsuneaki Kenzaka,¹ Masanobu Okayama,² Shigehiro Kuroki,¹ Miho Fukui,³ Shinsuke Yahata,³ Hiroki Hayashi,³ Akihito Kitao,³ Eiji Kajii,² Masayoshi Hashimoto^4
1Division of General Medicine, ²Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke; ³Department of General Medicine, Toyooka Public Hospital, Toyooka; ⁴Department of Family and Community Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

Background: The aim of this study was to evaluate the clinical usefulness of a semiquantitative procalcitonin kit for assessing severity of sepsis and early determination of mortality in affected patients.
Methods: This was a prospective, observational study including 206 septic patients enrolled between June 2008 and August 2009. Disseminated intravascular coagulation (DIC), Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II scores were measured, along with semiquantitative procalcitonin concentrations. Patients were divided into three groups based on their semiquantitative procalcitonin concentrations (group A, <2 ng/mL; group B ≥ 2 ng/mL < 10 ng/mL; group C ≥ 10 ng/mL).
Results: A significant difference in DIC, SOFA, and APACHE II scores was found between group A and group C and between group B and group C (P < 0.01). Patients with severe sepsis and septic shock had significantly higher procalcitonin concentrations than did patients with less severe disease. The rate of patients with septic shock with high procalcitonin concentrations showed an upward trend. There was a significant (P < 0.01) difference between the three groups with regard to numbers of patients and rates of severe sepsis, septic shock, DIC, and mortality.
Conclusion: Semiquantitative procalcitonin concentration testing can be helpful for early assessment of disease severity in patients with sepsis. Furthermore, it may also help in predicting early mortality in septic patients. Based on the level of semiquantitative procalcitonin measured in patients with suspected sepsis, a timely decision can be reliably made to transfer them to a tertiary hospital with an intensive care unit for optimal care.

Keywords: sepsis, semiquantitative procalcitonin, Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, mortality, procalcitonin