This article is part of the supplement: 22nd International Symposium on Intensive Care and Emergency Medicine
Comparing C-reactive protein, procalcitonin, and interleukin-6 for the diagnosis of bacterial infection in adult atraumatic patients in a medical center emergency department
Emergency Department, Chang Gung Memorial Hospital. 199, Tung Hwa North Road, Taipei, Taiwan
Critical Care 2002, 6(Suppl 1):P109 doi:10.1186/cc1562
The electronic version of this article is the complete one and can be found online at:
| Published: | 1 March 2002 |
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Introduction
Procalcitonin (PCT) has been proposed as a marker of sepsis in the critically ill patients. Its level is related to the severity of sepsis. We investigated the value of PCT, comparing with C-reactive protein (CRP) and interleukin (IL)-6, in the detection of infection in the emergency department (ED).
Methods
Ninety adult atraumatic patients admitted through the ED of a tertiary university hospital in June 2001 were consecutively enrolled. Forty-five were infected, and 31 were not infected. The serum levels of CRP (mg/l), PCT (ng/ml) and IL-6 (pg/ml) were compared between the infected and noninfected groups of patients. Mann-Whitney U test and chi-square test were employed to compare independent and group data, and the receiver operating characteristics (ROC) curve and the respective areas under the curve were calculated.
Results
The best cut-off level for CRP, PCT and IL-6, identified using Youden's Index, was 60 mg/l, 0.6 ng/ml and 24 pg/ml, respectively. Compared with CRP and IL-6, PCT had a comparable sensitivity, a lower specificity, and a lower area under the ROC curve. Bacteremic patients had higher PCT and IL-6 concentrations than those without bacteremia, but similar CRP concentrations. PCT and IL-6 levels were particularly high in septic shock patients.
Conclusions
PCT is not a better marker of infection than CRP and IL-6 in the adult ED patients, but it is a useful marker of the severity of infection.