Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department

被引:6
作者
Leroux, Pierre [1 ]
De Ruffi, Sebastien [1 ]
Ramont, Laurent [2 ,3 ,4 ]
Gornet, Marion [1 ]
Giordano Orsini, Guillaume [1 ,5 ]
Losset, Xavier [1 ]
Kanagaratnam, Lukshe [5 ,6 ]
Gennai, Stephane [1 ,5 ]
机构
[1] Reims Univ Hosp, Emergency Dept, 45 Rue Cognacq Jay, F-51100 Reims, France
[2] Reims Univ Hosp, Biochem Dept, 45 Rue Cognacq Jay, F-51100 Reims, France
[3] Univ Reims, SFR CAPSante FED 4231, Lab Biochim Med & Biol Mol, 51 Rue Cognacq Jay, F-51100 Reims, France
[4] CNRS, UMR 7369, Matr Extracellulaire & Dynam Cellulaire MEDyC, 45 Rue Cognacq Jay, F-51100 Reims, France
[5] INSERM, UMR S1250, Pathol Pulmonaires & Plasticite Cellulaire P3Cell, 45 Rue Cognacq Jay, F-51100 Reims, France
[6] Reims Univ Hosp, Clin Res Unit, 45 Rue Cognacq Jay, F-51100 Reims, France
关键词
C-REACTIVE PROTEIN; BLOOD-CELL COUNT; ELDERLY-PATIENTS; SEPTIC SHOCK; SEPSIS; BIOMARKERS; BACTERIAL; MORTALITY;
D O I
10.1155/2021/2344212
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Procalcitonin (PCT) may be useful for early risk stratification in the emergency department (ED), but the transposition of published data to routine emergency practice is sometimes limited. An observational retrospective study was conducted in the adult ED of the Reims University Hospital (France). Over one year, 852 patients suspected of infection were included, of mean age 61.7 years (SD: 22.6), and 624 (73.2%) were hospitalized following ED visit. Overall, 82 (9.6%) patients died during their hospitalization with an odds ratio (OR) of 5.10 (95% CI: 2.19-11.87) for PCT >= 0.5, in multivariate logistic regression analyses. Moreover, 78 (9.2%) patients were admitted to an ICU, 74 (8.7%) had attributable bacteremia, and 56 (6.6%) evolved toward septic shock with an OR of 4.37 (2.08-9.16), 6.38 (2.67-15.24), and 6.38 (2.41-16.86), respectively, for PCT >= 0.5. The highest discriminatory values were found for patients with age <65 years, but PCT lost its discrimination power for in-hospital mortality in patients with a bronchopulmonary infection site or a temperature >= 37.8 degrees C and for ICU admission in patients with severe clinical presentations. PCT could be helpful in risk stratification, but several limitations must be considered, including being sometimes outperformed by a simple clinical examination.
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页数:8
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