Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis

Tang, Benjamin; Eslick, Guy D.; Craig, Jonathan C.; McLean, Anthony S.

doi:10.1016/s1473-3099(07)70052-x

Cited by 753 publications

(496 citation statements)

References 73 publications

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“…The use of procalcitonin [64,144,145] or similar biomarkers may facilitate discontinuance of antibiotics in a patient with clinical improvement, although one recent study failed to show any benefit of daily procalcitonin measurement [146]. Table 4) should be rapidly referred to an intensive care unit (ICU) In 2004, the "Surviving Sepsis Campaign" guidelines recommended the use of EGDT [147] based on one large randomized trial [93].…”

Section: The Empirical Treatment Must Be Optimized When Microbiology mentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a review of recent literature in these topics

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Section: The Empirical Treatment Must Be Optimized When Microbiology mentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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“…3 Several meta-analyses have assessed procalcitonin as a marker of sepsis. [4][5][6][7][8][9] The fi ndings of these reports confl ict with regards to the association between procalcitonin and improved patient outcomes-eg, adequate treatment, mortality, or length of stay in the intensive-care unit. These discrepancies are probably a result of confounders such as treatment and population heterogeneity, diagnostic challenges related to identifi cation of the causative pathogens, absence of a true reference standard, the complexity of sepsis, diff erences in assay sensitivity, and shortcomings in the methods of the studies with inadequate statistical power to detect changes for hard endpoints.…”

Section: Procalcitonin As Diagnostic Biomarker Of Sepsismentioning

confidence: 99%

Procalcitonin as diagnostic biomarker of sepsis

Afshari

Harbarth

2013

The Lancet Infectious Diseases

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“…Beispielsweise kommt eine Meta-Analyse von Tang et al zu dem Ergebnis, dass PCT keine eindeutige Differenzierung zwischen Sepsis und SIRS durch nicht-infekti ö se Ursachen erm ö glicht [99] . Diese unterschiedlichen Ergebnisse werden durch verschiedene Einschlusskriterien sowie andere Messmethoden erkl ä rt [103,104] .…”

Section: Bakterielle Infektionenunclassified

Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen?/Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

Boenisch

Fae

Drexel

et al. 2013

Laboratoriumsmedizin

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Zusammenfassung :In der Diagnostik von Infektionen und inflammatorischen Prozessen ist das C-reaktive Protein (CRP) einer der meistverwendeten Parameter, unter anderem aufgrund der geringen Kosten und der schnellen Verf ü gbarkeit. Im Zuge der letzten Jahre gewannen jedoch andere Entz ü ndungsparameter, wie zum Beispiel das Interleukin 6 (IL-6) oder Procalcitonin (PCT), zunehmend an Bedeutung. Obwohl diese Parameter im klinischen Alltag noch nicht ü berall etabliert sind, besitzen sie doch wesentliche Vorteile in der Diagnostik und im Verlaufsmonitoring von entz ü ndlichen Erkrankungen. Beispielsweise ist die Erkennung entz ü ndlicher Komplikationen auf Intensivstationen durch erh ö hte IL-6 Spiegel 24 bis 48 Stunden vor einer Erh ö hung des CRP m ö glich. Die deutliche Ü berlegenheit von PCT gegen ü ber CRP in der Diagnostik von bakteriellen Infektionen und Sepsis begr ü ndet sich in der h ö heren Spezifit ä t des PCT f ü r bakterielle Infektionen. Der PCT-Verlauf erm ö glicht daher eine bessere Beurteilung des Therapieerfolges und Krankheitsverlaufs des Patienten und liefert Hinweise auf eine gegebenenfalls erforderliche Therapieumstellung. Daraus ergibt sich die Frage, ob die Messung des CRPSpiegels durch IL-6 und/oder PCT ersetzt werden kann. In dieser Ü bersichtsarbeit wird die derzeitige Bedeutung von CRP im Verh ä ltnis zu den neueren Entz ü ndungsparametern in der Diagnostik von bakteriellen Infektionen, im therapeutischen Monitoring und in seiner Aussagekraft bez ü glich der Prognose des Patienten auf Intensivstationen dargestellt.Schl ü sselw ö rter: C-reaktive Protein (CRP); Entz ü ndungsmarker; Infektion; Intensivstation; Interleukin 6 (IL-6); Procalcitonin (PCT); Sepsis.Abstract : C-reactive protein (CRP) currently constitutes one of the most widely used parameters for the diagnosis of infections and inflammatory processes, due to simple methods and low costs. However, in recent years, other parameters, such as interleukin 6 (IL-6) and procalcitonin (PCT), have gained in importance. Although these parameters are presently not established everywhere in clinical routine, they provide significant advantages in the diagnosis and monitoring of inflammatory diseases. For instance, in intensive care, the increase in IL-6 levels may indicate inflammatory complications 24 to 48 h prior to the increase in circulating CRP levels. In contrast to CRP, PCT shows a higher specificity for bacterial infections, which facilitates the diagnosis of bacterial infections and sepsis. Therefore, PCT values provide a better evaluation of prognosis and therapeutic success and of a necessary change in therapy. These points raise the question whether CRP levels should at least in part be replaced by PCT and/or IL-6. Thus, this review seeks to examine the value of CRP in relation to PCT and IL-6 in the diagnosis of bacterial infections, in therapeutic monitoring, and regarding prognosis in critical care patients.

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Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis

Cited by 753 publications

References 73 publications

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Procalcitonin as diagnostic biomarker of sepsis

Spielen CRP-Spiegel neben IL-6 und PCT noch eine Rolle für Patienten auf Intensivstationen?/Are circulating levels of CRP compared to IL-6 and PCT still relevant in intensive care unit patients?

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