Biomarkers for risk stratification and antibiotic stewardship in elderly patients

Falcone, Marco; Bauer, Michael; Ferrer, Ricard; Gavazzi, G.; Castillo, Juan González del; Schuetz, Philipp

doi:10.1007/s40520-023-02388-w

Cited by 13 publications

(6 citation statements)

References 116 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It can be applied in older patients using similar cutoff values as in younger patients [63] demonstrating comparable performance and higher diagnostic accuracy than Fig. 4 Clinical picture in older patients may be ambiguous other markers [55]. Serial PCT measurements can guide antibiotic therapy duration, reducing exposure without compromising recovery.…”

Section: Diagnosis Of Sepsismentioning

confidence: 99%

“…However, their performance may differ in older patients due to comorbidities and chronic inflammation. Clinical judgment and comprehensive assessment are necessary when using biomarkers in this population [ 55 ].…”

Section: Introductionmentioning

confidence: 99%

“…Serum procalcitonin (PCT) is a valuable biomarker for bacterial infections and sepsis prognosis [ 59 – 62 ]. It can be applied in older patients using similar cutoff values as in younger patients [ 63 ] demonstrating comparable performance and higher diagnostic accuracy than other markers [ 55 ]. Serial PCT measurements can guide antibiotic therapy duration, reducing exposure without compromising recovery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The critically ill older patient with sepsis: a narrative review

Ibarz,

Haas,

Ceccato

et al. 2024

Ann. Intensive Care

View full text Add to dashboard Cite

Sepsis is a significant public health concern, particularly affecting individuals above 70 years in developed countries. This is a crucial fact due to the increasing aging population, their heightened vulnerability to sepsis, and the associated high mortality rates. However, the morbidity and long-term outcomes are even more notable. While many patients respond well to timely and appropriate interventions, it is imperative to enhance efforts in identifying, documenting, preventing, and treating sepsis. Managing sepsis in older patients poses greater challenges and necessitates a comprehensive understanding of predisposing factors and a heightened suspicion for diagnosing infections and assessing the risk of sudden deterioration into sepsis. Despite age often being considered an independent risk factor for mortality and morbidity, recent research emphasizes the pivotal roles of frailty, disease severity, and comorbid conditions in influencing health outcomes. In addition, it is important to inquire about the patient's preferences and establish a personalized treatment plan that considers their potential for recovery with quality of life and functional outcomes. This review provides a summary of the most crucial aspects to consider when dealing with an old critically ill patient with sepsis.

show abstract

Section: Diagnosis Of Sepsismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The critically ill older patient with sepsis: a narrative review

Ibarz,

Haas,

Ceccato

et al. 2024

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…PCT is the precursor peptide of calcitonin, which regulates calcium homoeostasis. PCT is released ubiquitously by parenchymal cells (mainly in the liver, the kidney, adipose tissue and muscle) in response to microbial toxins and to several pro-inflammatory cytokines, in particular IL-1β, tumor-necrosis factor (TNF)-α and IL-6 ( Falcone et al, 2023 ). PCT can discriminate bacterial and fungal infections with access to the systemic circulation from viral infections.…”

Section: Indicators Of Sepsis and Septic Encephalopathymentioning

confidence: 99%

Septic encephalopathy in the elderly – biomarkers of potential clinical utility

Schütze,

Drevets,

Tauber

et al. 2023

Front. Cell. Neurosci.

View full text Add to dashboard Cite

Next to acute sickness behavior, septic encephalopathy is the most frequent involvement of the brain during infection. It is characterized by a cross-talk of pro-inflammatory cells across the blood–brain barrier, by microglial activation and leukocyte migration, but not by the entry of infecting organisms into the brain tissue. Septic encephalopathy is very frequent in older persons because of their limited cognitive reserve. The predominant clinical manifestation is delirium, whereas focal neurological signs and symptoms are absent. Electroencephalography is a very sensitive method to detect functional abnormalities, but these abnormalities are not specific for septic encephalopathy and of limited prognostic value. Routine cerebral imaging by computer tomography usually fails to visualize the subtle abnormalities produced by septic involvement of the brain. Magnetic resonance imaging is by far more sensitive to detect vasogenic edema, diffuse axonal injury or small ischemic lesions. Routine laboratory parameters most suitable to monitor sepsis, but not specific for septic encephalopathy, are C-reactive protein and procalcitonin. The additional measurement of interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor-α increases the accuracy to predict delirium and an unfavorable outcome. The most promising laboratory parameters to quantify neuronal and axonal injury caused by septic encephalopathy are neurofilament light chains (NfL) and S100B protein. Neuron-specific enolase (NSE) plasma concentrations are strongly influenced by hemolysis. We propose to determine NSE only in non-hemolytic plasma or serum samples for the estimation of outcome in septic encephalopathy.

show abstract

“…Moreover, treating infections in older patients can be difficult as their symptoms and signs may not be specific, leading to both over and undertreatment. Additionally, they have a weaker immune response to infections, which can affect the kinetics of biomarkers of infection [13]. When interpreting admission biomarkers for older adults with infections, caution must be taken as their prognostic abilities are lower in comparison to younger adults [14,15].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Report on the Influence of Acute Inflammation on Adiponectin Levels in Older Inpatients with Different Nutritional Status

Husejko,

Gackowski,

Wojtasik

et al. 2024

IJMS

View full text Add to dashboard Cite

Inflammation can be triggered by a variety of factors, including pathogens, damaged cells, and toxic compounds. It is a biological response of the immune system, which can be successfully assessed in clinical practice using some molecular substances. Because adiponectin, a hormone released by adipose tissue, influences the development of inflammation, its evaluation as a potential measure of inflammation in clinical practice is justified. In the present contribution, statistical comparison of adiponectin concentration and selected molecular substances recognized in clinical practice as measures of inflammation were utilized to demonstrate whether adipose tissue hormones, as exemplified by adiponectin, have the potential to act as a measure of rapidly changing inflammation when monitoring older hospitalized patients in the course of bacterial infection. The study showed no statistically significant differences in adiponectin levels depending on the rapidly changing inflammatory response in its early stage. Interestingly, the concentration of adiponectin is statistically significantly higher in malnourished patients than in people with normal nutritional levels, assessed based on the MNA. According to the results obtained, adiponectin is not an effective measure of acute inflammation in clinical practice. However, it may serve as a biomarker of malnutrition in senile individuals.

show abstract

Biomarkers for risk stratification and antibiotic stewardship in elderly patients

Cited by 13 publications

References 116 publications

The critically ill older patient with sepsis: a narrative review

The critically ill older patient with sepsis: a narrative review

Septic encephalopathy in the elderly – biomarkers of potential clinical utility

Preliminary Report on the Influence of Acute Inflammation on Adiponectin Levels in Older Inpatients with Different Nutritional Status

Contact Info

Product

Resources

About