Evaluation of serum amyloid-A protein in the diagnosis of sepsis among children at PICU of Al Zahraa University Hospital.

Abstract

The early and efficient diagnosis of sepsis in critically ill children remains a difficult task as the clinical signs are nonspecific. Complete blood count parameters and C‑reactive protein have low sensitivity., Also, the difficulty of its diagnosis may be due to decreased positive values of blood culture and the need for longtime to detect blood culture results. The serum Amyloid A (SAA) protein level in the blood increases earlier and up to 1000‑fold in response to inflammation. This study aimed to assess the role of SAA as diagnostic and prognostic marker in pediatric sepsis in the first 24 hours after pediatric intensive care unit (PICU) admission. This case-control study included 45 children with sepsis admitted at PICU from May 2023 to March 2024 and 45 children with matched age and sex as controls. We investigated SAA level in the same time with routine laboratory investigations of both groups. SAA level was higher in the patient group, ranged from 0.9 to 47.2 µg/m, with median 4.54 µg/ml, as compared to the control group with median 0.58 µg/ml ranged from 0 to 2.3 µg/ml. (p ≤0.001). Also, SAA level was significantly lower in the survived group with median 13.6 µg/ml, ranged from 5.7 to 20 µg/ml than the non-survived group with a median of 32.3 µg/ml; ranged from 30.3 to 47.2 µg/ml. In conclusion, we found that SAA was extremely high in critical and extremely critical ill patients which can be used as a predictor of mortality in severe sepsis among children.