Evaluation of the Role of Procalcitonin and D-Dimer Level in the Early Detection of Sepsis

Sepsis is defined as the presence (probable or documented) of infection along with a systemic inflammatory response to that infection. It is a life-threatening condition that causes millions of deaths globally each year. Early identification of patients at high risk of dying from sepsis may help initiate rapid and appropriate therapeutic interventions, significantly impacting sepsis-related morbidity and mortality. However, accurately assessing patients at risk for poor clinical outcomes poses a challenge for clinicians. Objective: This study aims to evaluate the validity of Procalcitonin (PCT) and D-dimer in patients with sepsis. Methodology: This cross-sectional observational study was conducted in the Department of Anaesthesiology & ICU atBangladesh Medical College Hospital, Dhaka, for six months following protocol acceptance.All data from the study were documented in a pre-formatted data collection sheet.The levels of Procalcitonin, D-dimer, lactate, and C-reactive protein were measured and compared in relation to the presence of sepsis.Subsequently, we calculated Sensitivity (%), Specificity (%), Positive Predictive Value (%), Negative Predictive Value (%), accuracy (%), and the correlation between sepsis and biochemical parameters for early diagnosis.The analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22.0, where necessary.For all statistical tests, a p-value of <0.05 was considered statistically significant.Result: The biochemical parameters associated with sepsis were elevated in both sepsis and non-sepsis groups compared to their reference values.However, the levels of Procalcitonin (36.38 11.61 vs 7.373.47ng/mL), D-Dimer (3.46 1.03 vs 2.11 0.6 mg/L), CRP (329.563.72 vs 329.5 63.72 mg/L), and Lactate (5.38 2.53 vs 3.17 1.85 mmol/L) were markedly higher in sepsis patients than in non-sepsis patients.Procalcitonin demonstrated the best predictive value for diagnosing sepsis, with a cut-off value of 0.64 ng/mL (AUC 0.832), Sensitivity of 88.5 %, Specificity of 97.56%, Positive Predictive Value of 91.52%, Negative Predictive Value of 75.0%, and accuracy of 86.2%.Conclusion: Both Procalcitonin and D-dimer could be effective for early prediction of sepsis in the ICU, but Procalcitonin was a more reliable biomarker than the others.