Efectividad del lactato versus procalcitonina como marcadores de mortalidad en sepsis: revisión Sistemática

Abstract

Sepsis is a dysregulated response of the body to an infection that can lead to organ dysfunction and death. Procalcitonin (PCT) is a biomarker of bacterial infection and systemic inflammatory response, while lactate indicates tissue hypoxia and metabolic abnormalities in sepsis. The objective of the study was to compare the effectiveness of lactate versus procalcitonin in predicting mortality in patients with sepsis. The search was conducted in PubMed, Scopus, and the Cochrane Library up to January 15, 2025. Studies involving patients with sepsis that evaluated lactate and procalcitonin in relation to mortality were included, excluding studies without relevant data or duplicates. Risk of bias was assessed using ROBINS-I and the Cochrane tool. The results showed that lactate and its derived indices, such as the lactate-to-albumin ratio, have a high predictive ability for mortality, with AUCs greater than 0.8, sensitivities of up to 87.1%, and specificities of up to 80.5%. PCT was useful for differentiating bacterial infections and improved diagnostic accuracy when combined with other biomarkers, achieving sensitivities of up to 93.9%. High methodological heterogeneity and risk of bias were identified due to differences in measurement methods and the studied populations. It is concluded that lactate is more effective for the early prediction of mortality in sepsis, while PCT improves diagnostic sensitivity when combined with other biomarkers. Keywords: sepsis, lactate, procalcitonin, mortality, effectiveness