Table 1 Characteristics of included studies

Miglietta et al. (2015) [19]

Retrospective study

One hundred forty-five critically ill patients with a mean age of 60

Utilizing PCT, CRP, and lactate in diagnosing SIRs, systemic candidiasis, and bacterial sepsis

Significantly higher levels of PCT were associated with Staphylococcus aureus at zero (0) days compared to other Gram-positive species. Besides, the PCT levels were significantly elevated in Gram-negative sepsis relative to the sepsis associated with Gram-positive bacteria. However, the P value was not much significant

Diagnostic sensitivity and specificity for PCT and CRP between bacterial sepsis and SIRS of sepsis were 85.7% and 83.3%, respectively. The positive and negative predictive values were 89.6% and 77.7%, respectively

Nakajima et al. (2014) [17]

Prospective study

Forty-five patients with sepsis comprised 29 male and 16 female patients of the age bracket of 57.2 ± 17.7 years old. Twenty-four pneumonia patients (15 men and nine women) of 70.5 ± 9.8 years old, with 56 control patients constituting 13 women and 43 men of age 62 ± 18.3 years

Clinical utilization of PCT as a marker of sepsis

The levels of PCT in the sepsis group showed statistically significant differences among the three groups. In the sepsis group, the PCT level was recorded as 29.3 ± 85.3 ng/mL, which was significantly higher than the PN levels (0.34 ± 8.6 ng/mL). In the control group, the level was 0.74 ± 2.1 ng/mL

The positive and negative predictive values for PCT were 85.7% and 51.6%, respectively. On the other hand, PCT sensitivity and specificity were 57.6% and 87.5%, respectively

Oliveira et al. (2013) [18]

Randomized clinical trial

Three hundred fifty-five adult patients of age 18 years were assessed for inclusion. Of these, 97 patients were randomized after excluding three, with 49 allocated to the PCT group and 45 to the CRP group. The mean age of the patients was 59.8 years, with a standard deviation of 16.8

In a randomized clinical trial, PCT and CRP guided antibiotic treatment and therapy in sepsis

The duration for the first episode of antibiotic therapy provided a similar result, with a 7-day median associated with the PCT group and a 6-day median for the CRP group. The antibiotic therapy number of days was more significant in the PCT group than in the CRP group during the follow-up period

Kece et al. (2016) [15]

Prospective study

Out of the 94 eligible patients, 86 cancer patients with a median age of 61 years

Comparison of the utility of lactate and Procalcitonin (PCT) levels in the diagnosis of sepsis in cancer patients

Concerning the diagnosis of sepsis, 0.8 ng/mL of PCT provided a specificity of 76.56% and a 63.64% sensitivity which was associated with a positive 2.72 LR with a 0.47 negative LR. The procalcitonin values alone cannot be suggested to distinguish sepsis from other non-infectious SIRS in adult patients with cancer to guide decisions made in the emergency department

PCT sensitivity and specificity were 63.64% and 76.56%, respectively, whereas the positive and negative predictive values were 2.72 and 0.47, respectively

Ulla et al. (2013) [16]

Prospective study

189 patients of 18 years and above

PCT was compared with presepsin in the emergency department’s diagnostic and prognostic management of sepsis

PCT was associated with higher diagnosis accuracies with areas under the curve (AUCs) of 0.875 compared to 0.701 presepsin. Septic patients had a high presepsin concentration, with a similar trend for mean PCT values

PCT was associated with higher sensitivity (89.47%) and specificity (75.90%)

Ko et al. (2016) [22]

Retrospective study

Among 574 patients identified for assessment, 49 were aged 24 to 88 (mean age of 67.2)

PCT was determined as an early indicator of progressive septic shock in sepsis patients associated with ureteral calculi at the emergency department (ED)

PCT is superior as a biomarker in diagnosing sepsis patients and predicting those at high risk of progressing septic shock in patients with urolithiasis

The sensitivity and specificity were 86.70% and 85.30%, respectively, for PCT diagnosis of sepsis among patients

Lin et al. (2017) [20]

Retrospective study

886 patents

PCT, lactate, high sensitivity CRP in bacteremia prediction of adult patients admitted in ED

PCT was associated with 0.72 for positive blood culture, with a 3.9 ng/mL derived opposite cutoff. Lactate was related to 0.6 with a corresponding 17.9 optimal cutoff. In contrast, CRP was 0.56 with 13 mg/dL optimal cutoff. PCT’s diagnostic odds ratio was 3.54 (95% CI 2.46–5.51), while the sensitivity and specificity were 81.0% and 47.0%, respectively. Similarly, PCT displayed 1.51 positive predictive value and 0.41 negative predictive value

Webb et al. (2020) [21]

Cohort study

148 patients of age bracket between 19 to 98 years with a median age of 72

PCT level related to positive blood culture (BC), septic shock, and in-hospital mortality associated with septic patients in ED

A 0.58 ng/mL corresponded to the median initial PCT with a 0.16–5.36 IQR. The median maximum of PCT was recorded at 2.1 ng/mL with a corresponding 0.3–11.1 IQR. Patients with negative BC had a median maximum PCT of 1.06 ng/mL compared to their positive BC counterparts with 4.19 ng/mL. PCT’s diagnostic odds ratio was 3.35 (95% CI 1.67–6.70)

Travaglino et al. (2012) [10]

Observational multicentric study

128 patients aged 18 years and above

PCT and Mid-regional pro-Adrenomedullin (MR-proADM) utility in ill febrile patients in ED, APACHE II comparison

The MR-proADM control values ranged between 0.4 to 0.58 nmol/L relative to 0.5–1.68 nmol/L in patients. Control PCT values ranged from 0.04 to 0.008 ng/mL against 0.1 to 3.4 ng/mL in patients. Patients admitted complaining of fever had 0.694 AUC for MR-proADM, while PCT was associated with an AUC of 0.763, with the combined use of both PCT and MR-proADM indicating an AUC of 0.79

Tsalik et al. (2012) [23]

Cohort study

336 patients

Inflammatory biomarkers value for suspected cases of sepsis

There is a high relationship between PCT and various sepsis-associated outcomes, such as the likelihood and severity of infection and septicemia. Similarly, both CRP and IL-6 were also associated with similar sepsis-related results. PCT’s sensitivity and specificity in sepsis diagnosis were 40.70% and 87.20%, respectively. Positive and negative predictive values for PCT sepsis diagnosis were 89.80% and 34.60%, respectively