Role of serum Procalcitonin as a Marker in Early Detection of Sepsis in Febrile ICU Patients

Abstract

Introduction: In intensive care units (ICUs), where early detection is essential to improve patient outcomes, sepsis continues to be a major cause of death. Though its diagnostic accuracy has to be further assessed in patients in the intensive care unit who are feverish, serum procalcitonin (PCT) has emerged as a potential biomarker for the early diagnosis of sepsis.

Methodology: A prospective observational study was conducted over 12 months at Lady Reading Hospital, Peshawar. Seventy-seven febrile ICU patients were enrolled. Serum Procalcitonin levels were measured at admission, and patients were classified as septic or non-septic based on Sepsis-3 criteria. Statistical analyses including ROC curve, sensitivity, specificity, and predictive values were performed to assess PCT’s diagnostic performance.

Results: Out of 77 patients, 49 (63.6%) were diagnosed with sepsis. Mean PCT levels were significantly higher in septic patients (6.58 ± 3.42 ng/mL) compared to non-septic patients (1.33 ± 1.11 ng/mL) (p < 0.001). A PCT cut-off of 2.1 ng/mL showed 89.8% sensitivity, 85.7% specificity, and an AUC of 0.931 for sepsis detection. Other inflammatory markers (CRP, TLC, lactate) were also elevated in septic patients.

Conclusion: Serum Procalcitonin is a reliable and effective biomarker for early sepsis detection in febrile ICU patients. Its use can improve diagnostic accuracy and enable timely management. Incorporation of PCT testing into routine ICU protocols is recommended to enhance sepsis care.