Additional value of procalcitonin for diagnosis of infection in patients with fever at the emergency department

Kruif, Martijn D. de; Limper, Maarten; Gerritsen, H.; Spek, C. Arnold; Brandjes, Dees P. M.; Cate, Hugo Ten; Bossuyt, Patrick M.; Reitsma, Pieter H.; Gorp, Eric C. M. Van

doi:10.1097/ccm.0b013e3181b9ec33

Cited by 65 publications

(45 citation statements)

References 35 publications

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“…20 The study was approved by the institutional scientific and ethics committee of the Slotervaart hospital, Amsterdam, The Netherlands. Written informed consent was obtained from all subjects.…”

Section: Study Design and Definitionsmentioning

confidence: 99%

PTX3 predicts severe disease in febrile patients at the emergency department

Kruif

Limper

Sierhuis

et al. 2010

Journal of Infection

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Section: Study Design and Definitionsmentioning

confidence: 99%

PTX3 predicts severe disease in febrile patients at the emergency department

Kruif

Limper

Sierhuis

et al. 2010

Journal of Infection

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“…Moreover, its serum levels can be helpful in predicting the presence of serious bacterial infection in children with fever but without localizing signs [10]. It has been recently documented [11] that, in the Emergency Department (ED), PCT may be a valuable addition to currently used markers for diagnosis of infection (including C-reactive protein--CRP), and for prognosis in patients with fever. PCT levels are significantly associated with admission to a special care unit, duration of intravenous antibiotic use, total duration of Fig.…”

Section: Procalcitonin In Sepsismentioning

confidence: 99%

Procalcitonin in acute cardiac patients

et al. 2010

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Procalcitonin (PCT) levels are below the detection level in healthy subjects, while pre-procalcitonin mRNA is over expressed in human medullar thyroid carcinoma, in small cell lung tumor, and occasionally in other rare neuroendocrine tumors such as phaeochromocytoma. PCT is known as a sensitive and specific biomarker for bacterial sepsis, being produced by extra-thyroidal parenchymal tissues, mainly hepatocytes. The increase in plasma level correlates with the severity of infection and the magnitude and the time course of its increase can be strictly related to the patient's outcome, and to the bacterial load. So far, data on serum PCT levels in patients with cardiogenic shock and in those with acute coronary syndromes (ACS) are scarce and controversial. While some studies report that PCT levels are increased in ACS patients on admission, other investigations document that plasma PCT concentrations are in the normal range. We recently reported that the degree of myocardial ischemia (clinically indicated by the whole spectrum of ACS, from unstable angina to cardiogenic shock following ST-elevation myocardial infarction) and the related inflammatory-induced response are better reflected by C-reactive protein (which was positive in most acute cardiac care patients of all our subgroups) than by PCT, which seems more sensitive to a higher degree of inflammatory activation, being positive only in patients with cardiogenic shock. Few studies investigated the dynamics of PCT in cardiac acute patients, and, despite the paucity of data and differences in patients' selection criteria, an increase in PCT values seems to be associated with the development of complications. In acute cardiac patients, the clinical values of procalcitonin rely not on its absolute value, but only on its kinetics over time.

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“…For such high-risk groups, biomarkers of infectionsuch as procalcitonin (PCT) and C-reactive protein (CRP)-and serum lactate as alternative independent predictors of mortality in sepsis have been studied in various clinical settings [16][17][18]. A combined use has also been suggested to improve prognostic accuracy among severely septic patients compared to their respective singular applications [19][20][21].…”

Section: >15mentioning

confidence: 99%

The Mortality in Emergency Department Sepsis Score as a Predictor of 1-Month Mortality among Adult Patients with Sepsis: Weighing the Evidence

Putra

Tiah

2013

ISRN Emergency Medicine

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Objective. To evaluate the performance of Mortality in Emergency Department Sepsis (MEDS) score in comparison to biomarkers as a predictor of mortality in adult emergency department (ED) patients with sepsis. Methods. A literature search was performed using PubMed, ScienceDirect, SpringerLink, and Ovid databases. Studies were appraised by using the C2010 Consensus Process for Levels of Evidence for prognostic studies. The respective values for area under the curve (AUC) were obtained from the selected articles. Results. Four relevant articles met the selection process. Three studies defined the 1-month mortality as death occurring within 28 days of ED presentation, while the remaining one subcategorised the outcome measure as (5-day) early and (6-to 30-day) late mortality. In all four studies, the MEDS score performed better than the respective comparators (C-reactive protein, lactate, procalcitonin, and interleukin-6) in predicting mortality with an AUC ranging from 0.78 to 0.89 across the studies. Conclusion. The MEDS score has a better prognostic value than the respective comparators in predicting 1-month mortality in adult ED patients with suspected sepsis.

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Additional value of procalcitonin for diagnosis of infection in patients with fever at the emergency department

Abstract: These data suggest that PCT may be a valuable addition to currently used markers of infection for diagnosis of infection and prognosis in patients with fever at the Emergency Department.

Cited by 65 publications

References 35 publications

PTX3 predicts severe disease in febrile patients at the emergency department

PTX3 predicts severe disease in febrile patients at the emergency department

Procalcitonin in acute cardiac patients

The Mortality in Emergency Department Sepsis Score as a Predictor of 1-Month Mortality among Adult Patients with Sepsis: Weighing the Evidence

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