Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission

Abstract

Infectious biomarkers such as procalcitonin (PCT) can help overcome the lack of sensitivity of the quick Sequential Organ Failure Assessment (qSOFA) score for early identification of sepsis in emergency departments (EDs) and thus might be beneficial as point-of-care biomarkers in EDs. Our primary aim was to investigate the diagnostic performance of PCT for the early identification of septic patients and patients likely to develop sepsis within 96 h of admission to an ED among a prospectively selected patient population with elevated qSOFA scores. In a large multi-centre prospective cohort study, we included all adult patients (n = 742) with a qSOFA score of at least 1 who presented to the ED. PCT levels were measured upon admission. Of the study population 27.3% (n = 202) were diagnosed with sepsis within the first 96 h. The area under the curve for PCT for the identification of septic patients in EDs was 0.86 (95% confidence interval (CI): 0.83–0.89). The resultant sensitivity for PCT at a cut-off of 0.5 µg/l was 63.4% (95% CI: 56.3–70.0). Furthermore, specificity was 89.2% (95% CI: 86.3–91.7), the positive predictive value was 68.8% (95% CI: 62.9–74.2), and the negative predictive value was 86.7% (95% CI: 84.4–88.7). The early measurement of PCT in a patient population with elevated qSOFA score served as an effective tool for the early identification of sepsis in ED patients.

Identification of novel biomarkers for sepsis diagnosis via serum proteomic analysis using iTRAQ‐2D‐LC‐MS/MS

“…Infection markers such as PCT and CRP are commonly used for the adjuvant diagnosis of sepsis, 4 , 5 and their role in the diagnosis and prediction of sepsis is still being explored. 45 , 46 In this study, a diagnostic model by a combination of the four validated indexes and two infection markers was established, with the highest AUC‐ROC of 0.772 than that of PCT or CRP, although there were no significant differences between each combination AUC and AUC of PCT or CRP. B2M, VCAM1, and ApoE, besides ApoC3, already can be detected in clinical laboratory, which provided the clinical application possibility for septic diagnosis.…”

NephroPOC – Proenkephalin A 119-159 predicts acute kidney injury and 28-day mortality in patients with suspected organ dysfunction in the emergency department (ED): secondary analysis from the prospective observational LifePOC study

“…In this secondary analysis of the recently published prospective, multicenter LifePOC study [19] the ability of the novel biomarker penKid to predict AKI within 48 h (de ned as an increase of Scr at least 0.3 mg/dl) and 28-day mortality among a heterogeneous cohort of ED patients with suspected organ dysfunction was externally validated. Our study shows that among this cohort penKid could predict AKI within 48 hours as well as within 24 and 72 hours and was associated with 28-day mortality.…”

A signature of immune-related genes correlating with clinical prognosis and immune microenvironment in sepsis

“…Several traditional prognosis indicators are applied in clinical practice today, including the Sequential Organ Failure Assessment [ 31 ], quick Sequential Organ Failure Assessment [ 32 ], the Acute Physiology and Chronic Health Evaluation II [ 33 ], the Simplified Acute Physiology Score II [ 34 ], and C-reactive protein/albumin ratio [ 35 ]. Nevertheless, their performances are limited in specificity and sensitivity so that they have facilitated early diagnosis and prognosis prediction in patients with sepsis [ 36 ].…”