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

Objectives:
The relation of procalcitonin (PCT) plasma concentrations compared
with C-reactive protein (CRP) was analyzed in patients with different severity
of multiple organ dysfunction syndrome (MODS) and systemic inflammation.

      Patients and methods:
      PCT, CRP, the sepsis-related organ failure assessment (SOFA)
            score, the Acute Physiology, Age, Chronic Health Evaluation (APACHE) II score
            and survival were evaluated in 40 patients with systemic inflammation and
            consecutive MODS over a period of 15 days.


      Results:
      Higher SOFA score levels were associated with significantly higher
            PCT plasma concentrations (SOFA 7-12: PCT 2.62 ng/ml, SOFA 19-24: PCT
            15.22 ng/ml) (median), whereas CRP was elevated irrespective of the scores
            observed (SOFT 7-12: CRP 131 mg/l, SOFT 19-24: CRP 135 mg/l). PCT of
            non-surviving patients was initially not different from that of survivors but
            significantly increased after the fourth day following onset of the disease,
            whereas CRP was not different between both groups throughout the whole
            observation period.


      Conclusions:
      Measurement of PCT concentrations during multiple organ
            dysfunction syndrome provides more information about the severity and the
            course of the disease than that of CRP. Regarding the strong association of PCT
            and the respective score systems in future studies we recommend evaluation also
            of the severity of inflammation and MODS when PCT concentrations were compared
            between different types of disease.