GIÁ TRỊ CHẨN ĐOÁN CỦA PROCALCITONIN TRONG PHÁT HIỆN NHIỄM KHUẨN HUYẾT TẠI KHOA CẤP CỨU BỆNH VIỆN ĐA KHOA TÂM ANH THÀNH PHỐ HỒ CHÍ MINH

Abstract

Objective: To evaluate the diagnostic value of procalcitonin (PCT) for early detection of sepsis in the Emergency Department of Tam Anh General Hospital, Ho Chi Minh City.

Subjects and Methods: A retrospective cross-sectional diagnostic study was conducted on 774 adult patients who underwent PCT testing in the Emergency Department from January 2025 to December 2025 and had sufficient data for Sepsis-3 assessment. Diagnostic performance was assessed using ROC analysis, and the optimal cut-off value was determined using the Youden index.

Results: Among 774 patients, 262 (33.9%) were diagnosed with sepsis. Median PCT levels were significantly higher in the sepsis group than in the non-sepsis group (2.62 ng/mL vs 0.13 ng/mL; p<0.001). PCT demonstrated good diagnostic performance with an AUC of 0.897 (95% CI: 0.872–0.919), outperforming CRP (AUC = 0.682; 95% CI: 0.637–0.731) and white blood cell count (AUC = 0.610; 95% CI: 0.553–0.667). The optimal cut-off value was 0.32 ng/mL, with sensitivity of 84.7%, specificity of 77.1%, positive predictive value of 65.5%, and negative predictive value of 90.8%. PCT showed weak positive correlations with SOFA (ρ = 0.168; p = 0.006) and SOFA-2 scores (ρ = 0.147; p = 0.017).

Conclusion: Procalcitonin demonstrated good diagnostic value for early detection of sepsis in the Emergency Department and outperformed CRP and white blood cell count. PCT may support early identification of suspected sepsis patients and initial risk stratification in emergency clinical practice.