Serum Procalcitonin vs SOFA Score in Predicting Outcome in Sepsis Patients in Medical Intensive Care Unit.

Background: Sepsis is a dysregulated host response to infection that leads to acute organ dysfunction. The Sequential Organ Failure Assessment (SOFA) score is one of the gold standard tests in assessing the patient's status during ICU stay and also to predict the clinical outcomes of the patients. Procalcitonin (PCT) is a more specific marker for bacterial infection. In this study, we compared PCT and SOFA scores in predicting morbidity and mortality outcomes in sepsis. Materials and methods: A prospective cohort study was conducted on 80 patients with suspected sepsis. Patients who were >18 years of age with suspected sepsis presenting to the emergency room within 24-36 hours of illness are included in the study. SOFA score was calculated, and blood was drawn for PCT at the time of admission. Results: The average SOFA score in survivors was 6.1 ± 1.93, whereas, in nonsurvivors, it was 8.3 ± 2.13. The average PCT level in survivors was 3.7 ± 1.5, whereas, in nonsurvivors, was 6.4 ± 3.13. Area under the curve (AUC) for serum procalcitonin was found to be 0.77 (p value = 0.001) with average procalcitonin level of 4.15 ng/mL with sensitivity of 70% and specificity of 60%. AUC of SOFA score was found to be 0.78 (p value = 0.001) with an average score of 8, having a sensitivity of 73% and specificity of 74%. Conclusion: Serum PCT and SOFA scores are significantly elevated in patients with sepsis and septic shock, indicating their utility in predicting the severity and also their ability to assess end-organ damage. How to cite this article: Shinde VV, Jha A, Natarajan MSS, Vijayakumari V, Govindaswamy G, Sivaasubramani S, et al. Serum Procalcitonin vs SOFA Score in Predicting Outcome in Sepsis Patients in Medical Intensive Care Unit. Indian J Crit Care Med 2023;27(5):348-351.

"The Great Masquerader": An Interesting Case Series of Pulmonary Thromboembolism.

Venous thromboembolism (VTE) encompasses pulmonary embolism (PE) and deep vein thrombosis (DVT). The clinical manifestations of pulmonary embolism are highly variable and non-specific. We report five cases of pulmonary embolism, each with a unique clinical profile and degree of severity. The clinical, electrocardiographic, and radiologic findings of each patient are described in this case series along with the appropriate therapy based on hemodynamic stability. It is crucial to distinguish between hemodynamically stable and unstable pulmonary embolism and treatment should be started right away to reduce morbidity and mortality secondary to obstructive shock.