Indonesian Journal of Clinical Pathology and Medical Laboratory
ISSN 0854-4263
Vol. 19 / No. 2 / Published : 2013-01
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Original Article :
Eosinopenia and procalcitonin in sepsis
Author :
- Danny Luhulima*1
- W. Hidayati*2
- IGAAP. Rejeki*3
- R. Permatasari *4
- Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
- Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
- Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
- Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
Abstract :
Sepsis is one of the common causes of morbidity and mortality in the ICU. Clinicians need to know and realize of good diagnostic markers to identify sepsis as early as possible. The role of eosinopenia as a marker of sepsis has recently been evaluated.The aim of this study was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to Procalcitonin. A cross sectional study was performed in 61 adult patients with SIRS, and blood of all patients were cultured. Further examinations were done for comparing the eosinophil count with the Procalcitonin levels if the blood culture was positive or when there were clinical signs which supported for sepsis. In this study there were fourty two patients enrolled. Procalcitonin level yielded a sensitivity of 90.0%, specificity of 83.3%, a positive predictive value (PPV) of 93.1% and a negative predictive value (NPV) of 76.9% at cut-off value of 2.75 ng/mL. The eosinophil (cut off £ 50 cells/uL) produced a sensitivity of 80.0%, specificity of 75.0%, PPV of 88.9%, and NPV of 60.0%. based on this study Procalcitonin appeared to be a more accurate diagnostic of sepsis than eosinopenia, but eosinopenia is still a helpful tool for clinicians, and may also be used as a diagnostic marker of sepsis, because it is highly sensitive, moderately specific , easy to measure, rapid and inexpensive as well. Sepsis merupakan penyebab tersering meningkatnya angka kematian dan kesakitan di ICU. Klinisi memerlukan petanda sepsis yang ideal. Akhir-akhir ini diteliti tentang eosinopenia sebagai petanda sepsis. Tujuan kajian ini ialah meneliti nilai eosinopenia yang dapat digunakan sebagai petanda sepsis dibandingkan dengan Procalcitonin. Penelitian ini menggunakan kajian potong silang terhadap 61 penderita SIRS dewasa. Semua penderita diambil sampel darah, kemudian dikultur. Jika hasil kultur darah terdapat pertumbuhan kuman dan terbukti ada sepsis, maka selanjutnya dibandingkan dengan jumlah eosinofil dan kadar PCT (Procalcitonin). Didasari pemeriksaan 61 penderita yang termasuk dalam patokan SIRS, diperoleh hasil PCT dengan kepekaan sebanyak 90%, kekhasan sebanyak 83,3%. Ditemukan pula nilai ramalan positif sebesar 93,1%, nilai ramalan negatif sebesar 76,9%, dalam cut-off 2,75 ng/mL. Di samping itu dalam jumlah eosinofil 50 sel/uL didapatkan kepekaan sebanyak 80%, kekhasan sebanyak 75%, nilai ramalan positif 88,9% dan nilai ramalan negatif 60%. PCT lebih tepat dalam mendiagnosis sepsis, dibandingkan dengan eosinopenia tetapi eosinopenia masih dapat digunakan sebagai petanda keadaan tersebut dengan kepekaan yang tinggi, kekhasan sedang, dan tidak memerlukan biaya yang mahal.
Keyword :
Eosinopenia, procalcitonin, sepsis,
References :
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