Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS

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Abstract
The relation of procalcitonin (PCT) plasma concentrations comparedwith C-reactive protein (CRP) was analyzed in patients with different severityof multiple organ dysfunction syndrome (MODS) and systemic inflammation. PCT, CRP, the sepsis-related organ failure assessment (SOFA)score, the Acute Physiology, Age, Chronic Health Evaluation (APACHE) II scoreand survival were evaluated in 40 patients with systemic inflammation andconsecutive MODS over a period of 15 days. Higher SOFA score levels were associated with significantly higherPCT plasma concentrations (SOFA 7-12: PCT 2.62 ng/ml, SOFA 19-24: PCT15.22 ng/ml) (median), whereas CRP was elevated irrespective of the scoresobserved (SOFT 7-12: CRP 131 mg/l, SOFT 19-24: CRP 135 mg/l). PCT ofnon-surviving patients was initially not different from that of survivors butsignificantly increased after the fourth day following onset of the disease,whereas CRP was not different between both groups throughout the wholeobservation period. Measurement of PCT concentrations during multiple organdysfunction syndrome provides more information about the severity and thecourse of the disease than that of CRP. Regarding the strong association of PCTand the respective score systems in future studies we recommend evaluation alsoof the severity of inflammation and MODS when PCT concentrations were comparedbetween different types of disease.