Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department
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)....
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2021/2344212 |
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| author | Pierre Leroux Sébastien De Ruffi Laurent Ramont Marion Gornet Guillaume Giordano Orsini Xavier Losset Lukshe Kanagaratnam Stéphane Gennai |
| author_facet | Pierre Leroux Sébastien De Ruffi Laurent Ramont Marion Gornet Guillaume Giordano Orsini Xavier Losset Lukshe Kanagaratnam Stéphane Gennai |
| author_sort | Pierre Leroux |
| collection | DOAJ |
| description | 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°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. |
| format | Article |
| id | doaj-art-a250a84132f143abbca08d5f11cbebcc |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-a250a84132f143abbca08d5f11cbebcc2025-02-03T07:23:28ZengWileyEmergency Medicine International2090-28402090-28592021-01-01202110.1155/2021/23442122344212Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency DepartmentPierre Leroux0Sébastien De Ruffi1Laurent Ramont2Marion Gornet3Guillaume Giordano Orsini4Xavier Losset5Lukshe Kanagaratnam6Stéphane Gennai7Emergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceEmergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceBiochemistry Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceEmergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceEmergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceEmergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceINSERM UMR-S1250, Pathologies Pulmonaires et Plasticité Cellulaire–P3Cell, 45 Rue Cognacq-Jay, Reims 51100, FranceEmergency Department, Reims University Hospital, 45 Rue Cognacq-Jay, Reims 51100, FranceProcalcitonin (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°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.http://dx.doi.org/10.1155/2021/2344212 |
| spellingShingle | Pierre Leroux Sébastien De Ruffi Laurent Ramont Marion Gornet Guillaume Giordano Orsini Xavier Losset Lukshe Kanagaratnam Stéphane Gennai Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department Emergency Medicine International |
| title | Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department |
| title_full | Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department |
| title_fullStr | Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department |
| title_full_unstemmed | Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department |
| title_short | Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department |
| title_sort | clinical outcome predictive value of procalcitonin in patients suspected with infection in the emergency department |
| url | http://dx.doi.org/10.1155/2021/2344212 |
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