A study of sepsis in the obstetric intensive care unit with special reference to biomarkers and scoring systems
Pooja Guwalani, Mayank Chotrani, Priyadarshini Tiwari
Objectives: To study the sensitivity and specificity of various biomarkers in cases diagnosed with sepsis in the obstetric critical care unit and to compare the clinical criteria with the biomarkers in these cases. Methods: A total of 52 patients admitted in the obstetric critical care unit of our institution with the diagnosis of sepsis were enrolled in the study and were assessed clinically on the basis of q SOFA and total SOFA scores and the quantitative assessment of biomarkers for sepsis, namely CRP, serum lactate and procalcitonin was done. The sensitivity and specificity of both clinical criteria and biomarkers was determined. Results: Our study confirmed the high sensitivity and specificity of serum lactate, followed by procalcitonin (PCT) among biomarkers in subjects suspected or diagnosed with sepsis. It was also found that q SOFA score had the highest sensitivity (78.9%) but low specificity (57.60%), in contrast to high specificity (84.80%) of total SOFA score, emphasizing the role of q SOFA score as a screening tool and the total SOFA score as a confirmatory tool in cases of sepsis. Conclusion: Serum lactate is the most sensitive and specific predictor of prognosis in cases of maternal sepsis, followed by procalcitonin. CRP (C-reactive protein) is the least specific of the biomarkers. q SOFA may be used for initial screening followed by total SOFA scores.