Role of decisive markers in diagnosis and outcome of patients with septic shock

ABSTRACT

This work aimed to assess the potential role of procalcitonin [PCT] and polymorphonuclear [PMN] elastase enzyme in the early diagnosis and early prediction of prognosis in patients with sepsis and septic shock. Twenty patients with septic shock [16 males and 4 females, mean age 50.15 years] together with a second group comprising 10 patients [9 males, mean age 49.2 years] with systemic sepsis without shock were studied. A third group including 20 healthy volunteers matching with age and sex and served as controls. Serum PCT and PMN elastase enzyme levels were estimated on admission for both patients and control groups with other laboratory investigations and clinical parameters. A multivariate discriminate analysis was performed using PCT, PMN elastase enzyme, albumin, alpha-1-antitrypsin, alpha-2 macroglobulin and C-reactive protein [CRP] as independent parameters. The study concluded that serum PCT and PMN elastase enzyme are independent useful diagnostic markers for the early detection of systemic inflammatory response syndrome with or without shock. However, PCT has the advantage over the above mentioned parameters having significantly predictive accuracy of 80%. Procalcitonin, PMN elastase enzyme, alpha-1-antitrypsin, alpha-2-macroglobulin, CRP and albumin could be used for the early prediction of complications of sepsis patients with an overall predictive accuracy of 76.7%