Comparative Study Of Procalcitonin Serum Level And Infection Probability Score For The Diagnosis And The Prognosis Of Severe Infection In ICU Patients

Objective Try to evaluate the performance of procalcitonin (PCT) and IPS as the marker of infection at onset of SIRS episode and 24 h later in prediction of hospital mortality in critically ill patients.Methods Patients: Critically ill patients with SIRS and/or uncertain shock. Measurements: The clinical status and biomarkers infection probability score (IPS) and PCT level (ng/ml) were observed .At cut-off values of PCT ≥ 0.5ng/ml and IPS>14 ,compared the value of diagnosis between the infectious SIRS and non-infectious SIRS. The outcome measure was mortality in 28 days , compare the predictive value of PCT and IPS between the survival and non-survival groups of patients.Results This prospective observational study consecutively enrolled 47 patients. 6 (12.8%)cases were diagnosed with non-infectious SIRS, 41(87.2%) cases were infectious SIRS.Compared with IPS, the serum PCT level had a little lower sensitivity (70.7% versus 75.6%), an ideal specificity (83.3% versus 66.7%). The Positive Likelihood Ratio(PLR) of PCT was better than IPS(4.24 versus 2.27). In addition, The variance of PCT and IPS were changed in parallel with the severity of the clinical condition of the patients, and showsignificant differences in either group (P<0.05).Conclusions: In the present study PCT was found to be a more accurate diagnostic parameter for differentiating infectious SIRS and non-infectious SIRS better than IPS. And repeated determinations of PCT and IPS may be helpful in the follow up of critically ill patients. Maybe PCT is a more ideal marker than IPS.