Rakesh Kumar, Deepika Rawtani, Shuchismita Kesarwani, Keshav Pathak, Anita Kumari, Sudhir Mehta, Nidhi Sharma

EVALUATION OF SEPSIS INDEX, IMMATURE GRACULOCYTE PERCENTAGE AND PROCALCITONIN FOR EARLY DIAGNOSIS OF SEPSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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Objective: The objective of this study is to determine and compare the sensitivity and specicity of serum procalcitonin, sepsis index, and immature granulocyte percentage for the early diagnosis of sepsis in CKD patients. Material and Methods: 50 patients of CKD with suspected sepsis were taken and divided into Group A (sepsis) and Group B (no sepsis) based on SOFA score. Blood samples were drawn from all patients within 24 hours of admission or at the time when clinical suspicion of sepsis was made, for relevant investigations, appropriate Pus/Urine culture, Body uid culture, X-ray, USG and CT scan were done for supportive diagnosis and the suspected source of infection based on clinical suspicion. Results: Procalcitonin had a sensitivity of 68.57%, specicity of 80%, and diagnostic accuracy of 72% for predicting sepsis in CKD patients. Sepsis index had a sensitivity of 74.29%, specicity of 86.67%, PPV of 92.86%, NPV of 59.09% and overall diagnostic accuracy of 78% for the diagnosis of sepsis in CKD patients. Immature granulocyte percent had a sensitivity of 60%, specicity of 66.7% and overall diagnostic accuracy of 62% for the diagnosis of sepsis in CKD patients. The combination of sepsis index and procalcitonin for the early diagnosis of sepsis in CKD patients had a sensitivity of 74.3%, specicity of 73.3%, and was found statistically signicant (p=0.008). Conclusion: In our study, we found that the sepsis index was most sensitive (74.29%) and specic (86.67%), and had the highest diagnostic accuracy (78%) among all three markers. Hence Sepsis index can be considered to be a better test vis a vis Procalcitonin for predicting sepsis in CKD patients.

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