Serum Procalcitonin (PCT) - Is there a Role as an Early Biomarker in Infected Diabetic Foot Ulcer (IDFU) Patients?
https://doi.org/10.5704/MOJ.2307.010
- Author:
Omar J
1
;
Ahmad NS
2
;
Che-Soh NAA
1
;
Wan-Azman WN
1
;
Yaacob NM
3
;
Abdul-Ghani NS
4
;
Abdullah MR
5
Author Information
1. Department of Chemical Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia
2. Department of Pathology, Hospital Bintulu Sarawak, Bintulu, Malaysia
3. Department of Biostatistic, Universiti Sains Malaysia, Kubang Kerian, Malaysia
4. Department of Orthopaedic, Universiti Sains Malaysia, Kubang Kerian, Malaysia
5. Department of Community Medicine, Universiti Sains Malaysia, Kubang Kerian, Malaysia
- Publication Type:Journal Article
- Keywords:
procalcitonin, biomarker, infected diabetic foot ulcer
- From:Malaysian Orthopaedic Journal
2023;17(No.2):62-69
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Infected diabetic foot ulcers may lead to
serious complications if not recognised in the early stage.
Diagnosis of infection is particularly challenging at that
stage; thus, a sensitive inflammatory biomarker may be
helpful. We aimed to evaluate the role of procalcitonin (PCT)
as an early biomarker for infected diabetic foot ulcers
(IDFU).
Materials and method: This cross-sectional study was
conducted at Klinik Rawatan Keluarga (KRK), Orthopedic
clinic and wards in Hospital Universiti Sains Malaysia
(USM) from May 2020 to December 2020. A total of 264
participants were recruited and divided into three groups: 50
diabetic patients with no ulcers (control), 107 patients with
non-infected diabetic foot ulcers (NIDFU), and 107 patients
with infected diabetic foot ulcers (IDFU). The level of PCT
was taken for all patients. Total white count (TWC) and Creactive protein (CRP) were taken only for IDFU patients.
Diagnosis of infection was based on the Infectious Disease
Society of America-International Working Group of Diabetic
Foot (IDSA-IMWGDF), and the severity of infection was
graded according to the Wagner Classification.
Results: The level of PCT was higher in IDFU than in
NIDFU and diabetic patient, with a median (IQR) of 0.355
(0.63) ng/mL, 0.077 (0.15) ng/mL and 0.028 (0.02) ng/mL,
respectively. PCT and CRP showed moderate positive
correlations in IDFU patients (p<0.001). The sensitivity and
specificity were 63.6% and 83.2%, respectively, at the best
cut-off at 0.25 ng/mL.
Conclusion: PCT is a valuable biomarker for the diagnosis
of infection; however, it adds little value in the early
diagnosis of IDFU in view of its low sensitivity.
- Full text:16.2023my1321.pdf
