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Usefulness of procalcitonin serum level for the discrimination of severe sepsis from sepsis: a multicenter prospective study
Authors:Shigeatsu Endo   Naoki Aikawa   Seitaro Fujishima   Isao Sekine   Kazuhiro Kogawa   Yasuhiro Yamamoto   Shigeki Kushimoto   Hidekazu Yukioka   Noboru Kato   Kyoichi Totsuka   Ken Kikuchi   Toshiaki Ikeda   Kazumi Ikeda   Hiroyuki Yamada   Kazuaki Harada  Shinji Satomura
Abstract:Procalcitonin serum level has been recommended as a new marker of bacterial infectious diseases. The aim of this prospective, multicenter study was to determine the clinical usefulness of procalcitonin in differentiating patients with sepsis from those with severe sepsis. Eighty-two patients were enrolled: 20 without systemic inflammatory response syndrome (SIRS), 9 with SIRS, 34 with sepsis, and 19 with severe sepsis. The patients with severe sepsis had significantly higher procalcitonin levels (median, 36.1 ng/ml) than those with sepsis (median, 0.6 ng/ml). With a procalcitonin cutoff value of 2.0 ng/ml, sensitivity for the detection of severe sepsis and specificity for the detection of sepsis were 94.7% and 78.1%, respectively. A good correlation was found between the serum procalcitonin level and the Sepsis-Related Organ Failure Assessment (SOFA) score (r = 0.680), although no correlation was found between the C-reactive protein (CRP) level and the SOFA score. In conclusion, the procalcitonin serum level may be useful not only for aiding the diagnosis of sepsis but also for discriminating between sepsis and severe sepsis.
Keywords:Procalcitonin  SIRS  Sepsis  SOFA score  APACHE II score
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