Original title: Discordance between initial procalcitonin and Sequential Organ Failure Assessment score predicts in-hospital mortality in culture-positive bacterial sepsis: a retrospective cohort from an Indonesian tertiary hospital
Suriana Dwi Sartika, Risna Halim, Sudirman Katu, Ariantin Ulfah · August 2026
Sepsis is a dangerous bodily response to an infection. Doctors often measure procalcitonin, a protein marker in blood, to judge infection severity, but a single test does not reliably predict outcomes. Researchers examined 441 adults with bacterial sepsis to see if comparing this protein to total organ failure helps. They looked for patients whose protein marker stayed surprisingly low despite severe organ damage. This mismatch points to severe illness without the expected immune signal. They found that patients with high organ failure but low procalcitonin suffered the highest in-hospital mortality rate at 90.4%. This mismatch strongly predicted death regardless of kidney health or bacteria type, providing an accessible way to spot high-risk patients early.
Imagine checking your car's dashboard. The oil light is off, but the engine is sputtering. Normally, a sputtering engine means low oil, but here the oil light is normal. That mismatch is dangerous. In this paper, a low infection marker (PCT) with high organ failure (SOFA) signals a hidden severe condition, just like the car's hidden problem.
For doctors in hospitals with limited resources, this finding offers a simple way to spot the sickest sepsis patients early. Instead of relying on expensive tests, they can combine a common blood test (procalcitonin) with a clinical score (SOFA) to identify a group with a 90% death rate. This can guide triage and aggressive treatment decisions, potentially saving lives.
The abstract doesn't explicitly state limitations. It does note that the study was retrospective, single-center, and limited to culture-positive bacterial sepsis at an Indonesian tertiary hospital. The effect was additive rather than synergistic, and specific cutoffs (PCT <2 ng/mL, SOFA ≥6) were used. Validation in other settings is needed.
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Discordance between initial procalcitonin and Sequential Organ Failure Assessment score predicts in-hospital mortality in culture-positive bacterial sepsis: a retrospective cohort from an Indonesian tertiary hospital — Suriana Dwi Sartika, Risna Halim, Sudirman Katu et al. — IJID regions — doi:10.1016/j.ijregi.2026.100987
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.