Evaluation of procalcitonin and sTREM-1 levels in the early diagnosis and monitoring of sepsis

Sepsis is still one of the major causes of morbidity and mortality despite the improvements of diagnosis and treatment in the modern medicine nowadays. Therefore, correct and rapid resulted laboratory examinations are needed to support the diagnosis. This study was planned to investigate the value of immunological indicators, such as procalcitonin and sTREM-1 in the differential diagnosis of patients with sepsis and SIRS and to measure the importance of them in determining the prognosis of patients with sepsis.Prospectively planned study included 41 patients with at least two SIRS criteria and sepsis patients, ages between 18 and 80 and hospitalized in Celal Bayar University (CBU) hospital between June 2008 and August 2009. A total of 74 patients, 41 SIRS and 33 sepsis, were studied. Blood samples were taken from SIRS patients at the 0 and 3rd day and from sepsis patients at the 0, 3rd, 4th, 7th, 14th, 20th days and clinical reviews were made according to the SOFA scoring system.As a result of statistical evaluation of the findings, both the SOFA scoring system, and procalcitonin and sTREM-1 were observed to be significant in the differential diagnosis of sepsis and SIRS patients (p <0.05). When the predictive values for procalcitonin and sTREM-1 were considered respectively, 1, 63 ng / ml and 199, 72 pg / ml, sensitivity and specificity were determined as 81,8% and 73,2% for both markers.When the value of clinical and laboratory markers were statistically evaluated in determining the prognosis of patients with sepsis, the SOFA scoring system had been identified as the most significant indicator. Procalcitonin levels showed fluctuation in patients with poor prognosis, while sTREM-1 levels had a progressive increase. Sensitivity and specificity rates of indicators were found to increase with longer follow-up period.As a result, in differentiation of sepsis and SIRS, as well as evaluating the prognosis of patients with sepsis, procalcitonin and sTREM-1 levels are highlighted to be important.Key words: Sepsis, SIRS, SOFA, sTREM-1, Procalcitonin