Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis

Kenzaka, Tsuneaki; Okayama, Masanobu; Kuroki, Shunsuke; Fukui, Miho; Yahata, Shinsuke; Hayashi, Hiroki; Kitao, Akihito; Kajii, Eiji; Hashimoto, Masayoshi

doi:10.2147/ijgm.s32758

Cited by 17 publications

(15 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results suggest a moderate relation between PCT level and outcome, in the specific population of septic patients with high PCT. As expected, we find a higher cutoff than previous studies performed in ED [ 3 , 15 – 17 ], but we also had a better specificity. In terms of patients’ recruitment, our results should be compared to those of Hur et al [ 7 ] who investigated the diagnostic and prognostic utility of PCT in critically ill patients with suspected sepsis in ED and ICU, for whom sepsis was diagnosed clinically or on PCT concentrations.…”

Section: Discussionsupporting

confidence: 84%

“…This previous meta-analysis pointed out the heterogeneity of the results observed in the studies. In the specific field of ED patients, there are few studies that report association of PCT level with mortality [ 15 – 17 ]. Authors present heterogeneity in methodologies (fully automated or semiquantitative assays), in reported cutoffs (from 0.9 to 10 µg/L), and in testing time (day 0, 1 or 5).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of PCT in septic emergency patients

Peschanski

Chenevier‐Gobeaux

Mzabi

et al. 2016

Ann. Intensive Care

View full text Add to dashboard Cite

BackgroundAn accurate assessment of septic patients at risk for poor clinical outcomes is challenging for clinicians in the emergency department (ED).Objectives We aimed to evaluate the prognostic value of procalcitonin (PCT) in septic patients in the ED for predicting death.ResultsIn a retrospective study, 188 septic patients (median age 63 [IQR 51–80]) of two French university hospitals were included. Patients who deceased within 30 days (20 %, n = 37) presented higher PCT value at admission (median 34.0 µg/L [5.0–71.9]) in comparison with the survivals (median 6.4 µg/L [4.1–13.1], p = 0.0005). ROC curve analysis indicated a moderate AUC of 0.686 [95 % CI 0.613–0.752] and an optimal PCT threshold value at 32.5 [95 % CI 21.8–43.3] µg/L that was associated with a 51 % [34–67] sensitivity, a 96 % [90–98] specificity, a 73 % [52–88] positive predictive value, and a 89 % [83–93] negative predictive value for death. Only 26 patients (14 %) had PCT values above this threshold (19 in the deceased group vs 7 in survival group, p < 0.0001). By multivariate analysis, only three variables remained significantly predictive of the death: personal history of cardiovascular disease (OR 3.1 [1.0–9.4], p = 0.046), the presence of severe sepsis/septic shock in the ER (OR 4.4 [1.3–12.3], p = 0.013), and a PCT level >32.5 µg/L (OR 36.0 [10.0–128.4], p < 0.0001). Similar results were obtained when considering the combined outcome death and/or admission in ICU.ConclusionElevated value of PCT at admission has moderate accuracy to identify poor outcome in ED septic patients in daily practice.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Prognostic value of PCT in septic emergency patients

Peschanski

Chenevier‐Gobeaux

Mzabi

et al. 2016

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…The included studies were published from 2000 to 2014. Thirteen studies [ 24 , 27 , 28 , 30 – 31 , 35 – 36 , 38 – 39 , 42 – 45 ] were conducted in Europe, eight [ 25 – 26 , 29 , 32 – 33 , 37 , 41 , 46 ] were conducted in Asia, one [ 40 ] was conducted in America, and one [ 34 ] in was conducted in Australia. With one exception [ 45 ], all studies were published in English.…”

Section: Resultsmentioning

confidence: 99%

Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A Systematic Review and Meta-Analysis

Liu¹,

Su²,

Han³

et al. 2015

PLoS ONE

152

130

View full text Add to dashboard Cite

Procalcitonin (PCT) has been widely investigated for its prognostic value in septic patients. However, studies have produced conflicting results. The purpose of the present meta-analysis is to explore the diagnostic accuracy of a single PCT concentration and PCT non-clearance in predicting all-cause sepsis mortality. We searched PubMed, Embase, Web of Knowledge and the Cochrane Library. Articles written in English were included. A 2 × 2 contingency table was constructed based on all-cause mortality and PCT level or PCT non-clearance in septic patients. Two authors independently evaluated study eligibility and extracted data. The diagnostic value of PCT in predicting prognosis was determined using a bivariate meta-analysis model. We used the Q-test and I 2 index to test heterogeneity. Twenty-three studies with 3,994 patients were included. An elevated PCT level was associated with a higher risk of death. The pooled relative risk (RR) was 2.60 (95% confidence interval (CI), 2.05–3.30) using a random-effects model (I 2 = 63.5%). The overall area under the summary receiver operator characteristic (SROC) curve was 0.77 (95% CI, 0.73–0.80), with a sensitivity and specificity of 0.76 (95% CI, 0.67–0.82) and 0.64 (95% CI, 0.52–0.74), respectively. There was significant evidence of heterogeneity for the PCT testing time (P = 0.020). Initial PCT values were of limited prognostic value in patients with sepsis. PCT non-clearance was a prognostic factor of death in patients with sepsis. The pooled RR was 3.05 (95% CI, 2.35–3.95) using a fixed-effects model (I 2 = 37.9%). The overall area under the SROC curve was 0.79 (95% CI, 0.75–0.83), with a sensitivity and specificity of 0.72 (95% CI, 0.58–0.82) and 0.77 (95% CI, 0.55–0.90), respectively. Elevated PCT concentrations and PCT non-clearance are strongly associated with all-cause mortality in septic patients. Further studies are needed to define the optimal cut-off point and the optimal definition of PCT non-clearance for accurate risk assessment.

show abstract

“…High PCT levels were reported to be related to increased morbidity and mortality in many patient populations such as those with pneumonia and severe sepsis [23,24,25,26]. …”

Section: Introductionmentioning

confidence: 99%

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Ergan

Şahin²,

Topeli

2016

Respiration

View full text Add to dashboard Cite

Background: Procalcitonin (PCT) is being used as a marker of bacterial infections. Although there are several studies showing the diagnostic yield of PCT to differentiate bacterial involvement in chronic obstructive pulmonary disease exacerbations (COPDE), the prognostic yield of PCT in severe COPDE has been studied less. Objectives: The primary aim was to determine whether the level of serum PCT at admission in severe COPDE serves as a prognostic biomarker for hospital mortality. The secondary aim was to determine the role of PCT in identifying a bacterial exacerbation. Methods: A total of 63 COPDE patients (median age 71 years; male 58.7%) were retrospectively analyzed from our intensive care unit database. Results: The hospital mortality rate was 23.8%. Admission PCT levels were higher in patients who died during hospitalization (0.66 vs. 0.17 ng/ml; p = 0.014). This association between hospital mortality and serum PCT level remained significant in a multivariate analysis; for every 1 ng/ml increase in PCT level, hospital mortality increased 1.85 times (odds ratio; 95% confidence interval: 1.07-3.19; p = 0.026). The optimal admission PCT threshold was 0.25 ng/ml in order to discern patients who had bacterial exacerbation with a sensitivity of 63%, a specificity of 67%, and a negative predictive value of 80%. The negative predictive value increased to 89% when both the admission and follow-up PCT levels remained <0.25 ng/ml. Conclusion: This study shows that admission PCT levels have a prognostic importance in estimating hospital mortality among patients with severe COPDE. A PCT level <0.25 ng/ml at the time of admission and during follow-up is suggestive of the absence of a bacterial cause of COPDE.

show abstract

Use of a semiquantitative procalcitonin kit for evaluating severity and predicting mortality in patients with sepsis

Cited by 17 publications

References 29 publications

Prognostic value of PCT in septic emergency patients

Prognostic value of PCT in septic emergency patients

Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A Systematic Review and Meta-Analysis

Serum Procalcitonin as a Biomarker for the Prediction of Bacterial Exacerbation and Mortality in Severe COPD Exacerbations Requiring Mechanical Ventilation

Contact Info

Product

Resources

About