Utility of procalcitonin versus CRP in early sepsis detection

Early sepsis detection remains challenging despite biomarker advances, with CRP widely used but PCT emerging as superior for bacterial infections in emergency settings. Therefore, it is of interest to compare the diagnostic accuracy of PCT and CRP in 284 emergency patients with suspected sepsis, using Sepsis-3 criteria and ROC analysis within 2 hours of presentation. PCT achieved higher AUC (0.847, 95% CI 0.812-0.882) versus CRP (0.721, 95% CI 0.680-0.762; p<0.001), with optimal cutoffs PCT 0.5 ng/mL and CRP 50 mg/L showing similar sensitivity (78.2% versus 82.1%) but PCT superior specificity. Septic patients exhibited markedly elevated PCT (median 2.8±4.2 ng/mL versus 0.3±0.8 ng/mL, p<0.001) and a faster peak time (6.2±2.1h versus 12.4±4.8h, p<0.001) than CRP. These data shows PCT's superior early diagnostic performance for emergency sepsis and thus supporting its adoption as a primary biomarker over CRP.