Role of Procalcitonin and C-reactive Protein as Predictors of Sepsis and in Managing Sepsis in Postoperative Patients: A Systematic Review

Abstract

Systemic inflammatory response syndrome (SIRS) and sepsis are inflammatory responses to infection or trauma, causing symptoms and adverse outcomes such as organ shutdown and death. Different scoring systems can help in the diagnosis of SIRS and sepsis. Several biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and white blood cells (WBCs) can serve as predictors of sepsis. Surgery, trauma, and burns are the non-inflammatory causes of SIRS and sepsis. In postoperative patients, both inflammatory and non-inflammatory causes of immune response may co-exist. The role of inflammatory biomarkers in identifying sepsis development, deciding to use antibiotics, and discharging patients needs further exploration and clarity. We searched medical databases such as PubMed/Medline, PMC, ScienceDirect, Cochrane Library, and Google Scholar for relevant medical literature. The identified papers were screened, eligibility criteria were applied, and 15 research papers were identified. The finalized papers explored the roles of CRP and PCT in postoperative patients. Both CRP and PCT are raised in a postoperative patient, and then, gradually, the levels decrease. However, in case of an infection, these levels continue to rise and signify an infection, which may progress to sepsis. The cut-off values can guide decision-making about when to start antibiotics and discharge the patient. PCT was found to be more reliable in identifying the infection and preventing the development of sepsis. Further research is needed to identify the exact cut-off values that can help in decision-making.

The Importance of Plasma Renin Concentration in Intensive Care Patients with Circulatory Shock

“…At univariate analysis, APACHE II, SOFA, and length of ICU stay, which were high in the shock patient group, were similar to those reported in septic shock patients in other studies [11,20]. Lactate values, which are prognostic in the diagnosis of tissue perfusion disorder [3,4,21], and procalcitonin and CRP values used in predicting prognosis in septic patients [10,22,23], were elevated in the shock group in this study. The prediction of survival by mottling score (p = 0.006), GFR (p = 0.025) and PRC (p = 0.038) at Cox analysis in the entire patient group was similar to that reported in other studies [4,15].…”

Comprehensive Review of Urinary Tract Infections in Renal Transplant Recipients: Clinical Insights and Management Strategies

“…Additionally, emerging urinary biomarkers like neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) are actively investigated for their potential in diagnosing and monitoring UTIs in transplant recipients. These biomarkers offer promising insights into renal health and function, allowing for early detection and monitoring of UTIs and ultimately improving patient care and outcomes [ 30 ].…”

Immunological and Prognostic Role of Hub Genes Defined Gene Signature in Septic Cardiomyopathy

“…In the early stage of septic cardiomyopathy, SIRS represented the uncontrolled hyperimmune response as the leading cause of death. However, with the development of supportive therapy, most patients can survive through SIRS and become more complex immunosuppressive CARS 5,6 . The coexistence and reinforcement of SIRS and CARS inevitably lead to immune-related severe injury, which might be the basis of septic cardiomyopathy 7 .…”