1. Procalcitonin in early rule-in/rule-out of sepsis in SIRS patients admitted to a medical ward
- Author
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Nicola Fiotti, Lorenza Mamolo, Enrico Chendi, Jacopo Lombardi, Daniele Orso, Maurizio Ruscio, Giovanni Fernandes, Andrea Breglia, Giulia Pivetti, Filippo Mearelli, Daniele Peric, Nicola Altamura, Margherita De Nardo, Pierandrea Vinci, Alberto Peretti, Gianni Biolo, Fiotti, Nicola, Mearelli, F, Ruscio, M, Altamura, N, Vinci, Pierandrea, Fernandes, Giovanni, DE NARDO, Margherita, Lombardi, J, Mamolo, Lorenza, Chendi, Enrico, Breglia, Andrea, Peretti, Alberto, Peric, Daniele, Orso, Daniele, Pivetti, Giulia, and Biolo, Gianni
- Subjects
Calcitonin ,Male ,medicine.medical_specialty ,Time Factors ,Calcitonin Gene-Related Peptide ,Clinical Biochemistry ,Procalcitonin ,Sepsis ,Patient Admission ,Internal medicine ,Intensive care ,parasitic diseases ,medicine ,SIRS ,Humans ,Medical ward ,Protein Precursors ,Intensive care medicine ,Aged ,Aged, 80 and over ,procalcitonin, sepsis, SIRS ,Receiver operating characteristic ,business.industry ,Biochemistry (medical) ,General Medicine ,Prognosis ,bacterial infections and mycoses ,medicine.disease ,Sepsis group ,Systemic inflammatory response syndrome ,Female ,business ,procalcitonin ,hormones, hormone substitutes, and hormone antagonists - Abstract
A relevant amount of patients with clinical suspect of sepsis is admitted and treated in medical wards (MW). These patients have a better prognosis but are older and with more comorbidities compared to those admitted to intensive care units (ICU). Procalcitonin (PCT) is extensively used in emergency departments for the diagnosis of sepsis, but its accuracy in the setting of a MW has not been thoroughly investigated. Predicted low PCT levels also call for the comparison of immunomagnetic-chemiluminescent (L-PCT) and time-resolved amplified cryptate emission (TRACE, K-PCT) technologies, in PCT determination.In 80 patients with systemic inflammatory response syndrome (SIRS) diagnostic criteria and suspect of sepsis newly admitted to a MW, PCT was determined with L- and K-PCT method.Sixty patients were diagnosed as sepsis (20 microbiologically and 40 clinically proven) and 20 with non-infective SIRS. The sepsis group had significantly higher levels of both PCTs, with no differences between the clinically and microbiologically proven subgroups. The areas under ROC curves for L- and K-PCT were 0.72 and 0.78 (pIn MW patients, customized PCT cut-off levels provide better accuracy than customary levels adopted from ICU, and TRACE technology seems to offer a wider analysis range.
- Published
- 2014