Calprotectin is superior to procalcitonin as a sepsis marker and predictor of 30-day mortality in intensive care patients

Scand J Clin Lab Invest. Feb-Apr 2020;80(2):156-161. doi: 10.1080/00365513.2019.1703216. Epub 2019 Dec 14.

Abstract

Sepsis is the most frequent cause of death in the intensive care unit (ICU). A rapid and correct diagnosis and initiation of therapy is crucial for improving patient outcomes. The aim of this study was to compare the performance of calprotectin with the more widely used sepsis biomarker procalcitonin (PCT) in ICU patients. The performance of calprotectin and PCT as sepsis and prognostic markers for 30-d mortality was compared in a prospective, observational study in an eight-bed ICU. We investigated concentrations of the biomarkers in plasma collected at admission from all ICU patients admitted during a year (2012-2013, n = 271) together with simplified acute physiology 3 scores (SAPS3) and sequential organ failure assessment (SOFA) scores. The receiver operating characteristic (ROC) analysis showed a higher area under the curve (AUC) value for calprotectin (0.79) than for PCT (0.49) when used as a sepsis marker. The calprotectin concentrations at admission were higher in non-survivors than in survivors at day 30. In our study, calprotectin was superior to PCT for distinguishing between ICU patients with sepsis and non-sepsis patients. Calprotectin also had higher predictive ability regarding 30-d mortality.

Keywords: Calprotectin; SAPS3; SOFA; intensive care; procalcitonin; sepsis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Leukocyte L1 Antigen Complex / blood*
  • Middle Aged
  • Organ Dysfunction Scores
  • Procalcitonin / blood*
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Sepsis / blood*
  • Sepsis / mortality*
  • Sweden / epidemiology
  • Wounds and Injuries / blood
  • Wounds and Injuries / mortality
  • Young Adult

Substances

  • Biomarkers
  • Leukocyte L1 Antigen Complex
  • Procalcitonin