The Contribution of Procalcitonin, C-Reactive Protein and Interleukin-6 in the Diagnosis and Prognosis of Surgical Sepsis: An Observational and Statistical Study

Abstract

Background Sepsis affects over 30 million people worldwide each year, causing approximately 6 million deaths. Challenges in clinical diagnosis and the need for an early diagnosis to prevent mortality due to sepsis have led to dependence on inflammatory biomarkers like Procalcitonin (PCT), C-reactive protein (CRP), and Interleukin-6 (IL-6). Objective This study was performed to observe the contribution of inflammatory biomarkers in the diagnosis and prognosis of patients with surgical sepsis. Methods We performed a retrospective observational study in a Clinical Emergency Hospital, which included a number of 125 patients with surgical sepsis admitted between January 2020 and December 2021. The patients were included in the study based on the Sepsis-3 definition. PCT, CRP, IL-6, Sepsis-related Organ Failure Assessment (SOFA) score, Charlson Comorbidity Index (CCI), the time up to surgery, the days of treatment in Intensive Care Unit (ICU) and the total days of hospitalization had been statistically analyzed. Results The mean age of all patients was 65.14 years. The mean value in all patients for PCT was 20.08 ng/mL, for CRP was 175.42 mg/l, and for IL-6 was 799.6 pg/mL. The strongest correlation between biomarkers was between CRP and IL-6 (r = 0.425; p < 0.0001). Of all biomarkers, the CRP correlated the strongest with patient outcomes (r = 0.544; p < 0.0001). The area under curve (AUC) for the mean values of the inflammatory biomarkers was calculated and the best diagnostic performance was for CRP with 0.816 (95% CI: 0.744–0.887). Conclusion CRP and IL-6 were the most efficient in sepsis diagnosis. The association of PCT, CRP and IL-6 has increased the range of certainty in sepsis diagnosis. CRP was the most efficient biomarker in the prognosis of sepsis.

Adverse outcomes and an immunosuppressed endotype in septic patients with reduced IFN-γ ELISpot

“…ELISpot has emerged as a powerful method to assess immunological status in a variety of clinical disorders (25)(26)(27)(28), including septic and critically ill patients (20,21,29,30). It offers several theoretical advantages over other current metrics -for example, cell phenotypes such as ALC (31)(32)(33)(34) and HLA-DR expression on CD14 + blood cells (35,36); plasma protein concentrations such as procalcitonin (37)(38)(39)(40), IL-6 (41)(42)(43), and sPD-L1 (44,45); or blood transcriptomics (24,46,47) -used to predict both the severity of the host response and the immunosuppressed endotype. ELISpot, unlike these static measures, assesses one component of the functional status of the host protective immune response.…”

Innovative Surgical Approaches That Improve Individual Outcomes in Advanced Breast Cancer

“…An increased risk for advanced breast tumors is the appearance of ulcers that can become infected very easily due to immunosuppression, which can lead to appearance of sepsis and septic shock. 3 Surgical treatment in such cases no longer corresponds to the standardized indications. Many times we need adjunctive treatment methods to bring the patient to an operable stage or to use innovative methods - such as in the case of metastatic disease.…”