Clinical Use of Procalcitonin in the Diagnosis of Sepsis: Evaluation of PCT-qSOFA

Abstract

Background: Sepsis is a life-threatening medical condition, and the diagnosis of sepsis should be conducted rapidly and accurately. The purpose of this study was to evaluate the diagnostic performance of a combination of procalcitonin (PCT) levels and quick sequential organ failure assessment (qSOFA), namely PCT–qSOFA, for the diagnosis of sepsis. Methods: A total of 204 patients were grouped according to the results of blood culture and systemic inflammatory response syndrome criteria (≥ 2/4) into the bacterial sepsis group (N = 67), the blood culture-negative sepsis group (N = 37), the blood culture-positive group without corresponding clinical symptoms or signs of sepsis (N = 35), and the control group without evidence of sepsis (N = 65). The diagnostic performance of PCT–qSOFA was assessed using the post-test probability analysis. Results: Compared with qSOFA, PCT–qSOFA demonstrated improved post-test probability (from 0.772 to 0.884) and a positive likelihood ratio (from 1.59 to 3.55) when it was applied to all subjects, including those in the intensive care unit (ICU). However, this improvement in diagnostic performance was not observed when PCT–qSOFA was applied to patients outside the ICU. Conclusions: The combined use of PCT and qSOFA can help clinicians identify patients with sepsis, including those in an ICU setting