A Comparative Analysis of Procalcitonin for Sepsis in Diabetic Ketoacidosis

• Published in: RUHS journal of health sciences Vol. 8; no. 3
• Main Authors: Bhandari, Sudhir, Rankawat, Govind, Lohmror, Anurag, Wadhawan, Lalit, Bhandari, Shiven, Gehlot, Mukesh
• Format: Journal Article
• Language: English
• Published: Sonali Sharma on behalf of Rajasthan University of Health Sciences 30-09-2023
• Subjects: Keywords: Diabetic ketoacidosis, Diabetes mellitus, Procalcitonin, Sepsis
• ISSN: 2456-8309; 2582-3590
• DOI: 10.37821/ruhsjhs.8.3.2023.606

Introduction: Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes mellitus (DM). Infections are the most common triggers of DKA. The early recognition of infection and its severity in DKA patients serves an important role in improving infection control and prognosis. Methodology: A total of 240 patients of DKA were recruited. After a complete history and clinical examination, investigations including hemogram, HbA1c, procalcitonin (PCT), blood, urine or infection site culture, chest radiograph, urine ketone by urinary ketone strip test, ABG, malaria by slide, serum amylase and lipase were carried out as per standard protocol. Results: The observed parameters viz. HbA1c, temperature at day two, total leucocyte count (TLC) at day two, PCT at admission and day two, and length of hospital stay were found to be significantly higher in patients with proven bacterial infection (PBI) as compared to patients without PBI (p<0.001). The mortality was significantly higher in the PBI group than without PBI. PCT was accurate at the admission to distinguish PBI episodes from those without PBI with a sensitivity of 100% and a specificity of 90% at a cut-off of 0.989 ng/ml. Conclusion: PCT (with a higher threshold than usual: 1.44 ng/mL) may help to distinguish patients with and without PBI. By using PCT as a marker of sepsis, reduction of antibiotic misuse may be possible.