Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study
Purpose. To investigate whether absolute value of procalcitonin (PCT) or the change (delta-PCT) is better indicator of infection in intensive care patients. Materials and Methods. Post hoc analysis of a prospective observational study. Patients with suspected new-onset infection were included in who...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2016/3530752 |
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| author | Domonkos Trásy Krisztián Tánczos Márton Németh Péter Hankovszky András Lovas András Mikor Edit Hajdú Angelika Osztroluczki János Fazakas Zsolt Molnár |
| author_facet | Domonkos Trásy Krisztián Tánczos Márton Németh Péter Hankovszky András Lovas András Mikor Edit Hajdú Angelika Osztroluczki János Fazakas Zsolt Molnár |
| author_sort | Domonkos Trásy |
| collection | DOAJ |
| description | Purpose. To investigate whether absolute value of procalcitonin (PCT) or the change (delta-PCT) is better indicator of infection in intensive care patients. Materials and Methods. Post hoc analysis of a prospective observational study. Patients with suspected new-onset infection were included in whom PCT, C-reactive protein (CRP), temperature, and leukocyte (WBC) values were measured on inclusion (t0) and data were also available from the previous day (t-1). Based on clinical and microbiological data, patients were grouped post hoc into infection- (I-) and noninfection- (NI-) groups. Results. Of the 114 patients, 85 (75%) had proven infection. PCT levels were similar at t-1: I-group (median [interquartile range]): 1.04 [0.40–3.57] versus NI-group: 0.53 [0.16–1.68], p=0.444. By t0 PCT levels were significantly higher in the I-group: 4.62 [1.91–12.62] versus 1.12 [0.30–1.66], p=0.018. The area under the curve to predict infection for absolute values of PCT was 0.64 [95% CI = 0.52–0.76], p=0.022; for percentage change: 0.77 [0.66–0.87], p<0.001; and for delta-PCT: 0.85 [0.78–0.92], p<0.001. The optimal cut-off value for delta-PCT to indicate infection was 0.76 ng/mL (sensitivity 80 [70–88]%, specificity 86 [68-96]%). Neither absolute values nor changes in CRP, temperature, or WBC could predict infection. Conclusions. Our results suggest that delta-PCT values are superior to absolute values in indicating infection in intensive care patients. This trial is registered with ClinicalTrials.gov identifier: NCT02311816. |
| format | Article |
| id | doaj-art-598f8c56f3fc429c8a1314aab16d74e0 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-598f8c56f3fc429c8a1314aab16d74e02025-08-20T03:34:37ZengWileyJournal of Immunology Research2314-88612314-71562016-01-01201610.1155/2016/35307523530752Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational StudyDomonkos Trásy0Krisztián Tánczos1Márton Németh2Péter Hankovszky3András Lovas4András Mikor5Edit Hajdú6Angelika Osztroluczki7János Fazakas8Zsolt Molnár9Faculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Division of Infectious Diseases, First Department of Internal Medicine, University of Szeged, Szeged, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryFaculty of Medicine, Department of Transplantation and Surgery, Semmelweis University, Budapest, HungaryFaculty of Medicine, Department of Anaesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, HungaryPurpose. To investigate whether absolute value of procalcitonin (PCT) or the change (delta-PCT) is better indicator of infection in intensive care patients. Materials and Methods. Post hoc analysis of a prospective observational study. Patients with suspected new-onset infection were included in whom PCT, C-reactive protein (CRP), temperature, and leukocyte (WBC) values were measured on inclusion (t0) and data were also available from the previous day (t-1). Based on clinical and microbiological data, patients were grouped post hoc into infection- (I-) and noninfection- (NI-) groups. Results. Of the 114 patients, 85 (75%) had proven infection. PCT levels were similar at t-1: I-group (median [interquartile range]): 1.04 [0.40–3.57] versus NI-group: 0.53 [0.16–1.68], p=0.444. By t0 PCT levels were significantly higher in the I-group: 4.62 [1.91–12.62] versus 1.12 [0.30–1.66], p=0.018. The area under the curve to predict infection for absolute values of PCT was 0.64 [95% CI = 0.52–0.76], p=0.022; for percentage change: 0.77 [0.66–0.87], p<0.001; and for delta-PCT: 0.85 [0.78–0.92], p<0.001. The optimal cut-off value for delta-PCT to indicate infection was 0.76 ng/mL (sensitivity 80 [70–88]%, specificity 86 [68-96]%). Neither absolute values nor changes in CRP, temperature, or WBC could predict infection. Conclusions. Our results suggest that delta-PCT values are superior to absolute values in indicating infection in intensive care patients. This trial is registered with ClinicalTrials.gov identifier: NCT02311816.http://dx.doi.org/10.1155/2016/3530752 |
| spellingShingle | Domonkos Trásy Krisztián Tánczos Márton Németh Péter Hankovszky András Lovas András Mikor Edit Hajdú Angelika Osztroluczki János Fazakas Zsolt Molnár Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study Journal of Immunology Research |
| title | Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study |
| title_full | Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study |
| title_fullStr | Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study |
| title_full_unstemmed | Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study |
| title_short | Delta Procalcitonin Is a Better Indicator of Infection Than Absolute Procalcitonin Values in Critically Ill Patients: A Prospective Observational Study |
| title_sort | delta procalcitonin is a better indicator of infection than absolute procalcitonin values in critically ill patients a prospective observational study |
| url | http://dx.doi.org/10.1155/2016/3530752 |
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