Protein C levels as a prognostic indicator of outcome in sepsis and related diseases.

OBJECTIVE: To consider the appropriateness of protein C levels as a prognostic indicator for sepsis and related diseases. DATA SOURCES/STUDY SELECTION: Published research and review articles related to protein C deficiency in patients with sepsis and related diseases. DATA EXTRACTION AND SYNTHESIS: All applicable data were extracted, and relevant literature was cited to support factual statements in the text. The protein C pathway represents one of the major regulatory systems of hemostasis, exhibiting antithrombotic, profibrinolytic, and anti-inflammatory properties. Numerous studies have shown that acquired protein C deficiency is prevalent in the majority of septic patients (>85%) and is associated with increased morbidity and mortality in patients with severe sepsis and septic shock. This deficiency in protein C is not simply a transient marker for sepsis, but parallels the progress of the disease. In addition, protein C deficiency occurs in the presence of a wide range of pathogens and develops early in the disease process.
CONCLUSIONS: A review of the relevant literature suggests that protein C levels may serve as a useful prognostic indicator of outcome in sepsis and related diseases.