The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis
Abstract Background Sepsis is a leading cause of morbidity and mortality among newborns. C-reactive protein (CRP) and procalcitonin (PCT) have some limitations in the diagnosis of preterm neonatal sepsis. In this study, the cut-offs of PCT and CRP, and the efficacy of mean platelet volume (MPV) were...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | BMC Pediatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12887-018-1236-2 |
| _version_ | 1818970992076128256 |
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| author | C. Aydemir H. Aydemir F. Kokturk C. Kulah A. G. Mungan |
| author_facet | C. Aydemir H. Aydemir F. Kokturk C. Kulah A. G. Mungan |
| author_sort | C. Aydemir |
| collection | DOAJ |
| description | Abstract Background Sepsis is a leading cause of morbidity and mortality among newborns. C-reactive protein (CRP) and procalcitonin (PCT) have some limitations in the diagnosis of preterm neonatal sepsis. In this study, the cut-offs of PCT and CRP, and the efficacy of mean platelet volume (MPV) were investigated. Methods We identified key demographic details and compared laboratory values between preterm infants with early onset and late onset neonatal sepsis (EONS/LONS) retrospectively. Blood samples were collected within the first few hours of the onset of clinical sepsis (CRP 1, PCT 1, MPV 1) and were repeated after 24 h (CRP 2, PCT 2, MPV 2). The optimal cut-offs for CRP, PCT and MPV were determined using receiver operating characteristic (ROC) analysis. Furthermore, pairwise comparisons of ROC curves were made to evaluate the performances of these tests. Results In EONS, the cut-off of CRP 1 was 2.6 mg/L, the sensitivity, specificity, PPV and NPV were 80.6, 83.0, 67.5 and 90.7%, respectively (p < 0.001). At a PCT 1 cut-off of 1.1 ng/mL, the sensitivity, specificity, PPV and NPV were 78.6, 81.2, 64.7 and 89.6%, respectively (p < 0.001). The sensitivity, specificity, PPV, and NPV of the CRP 1 cut-off of 3.6 mg/L for LONS were 78.3, 87.4, 74.8, and 89.4%, respectively. At a PCT 1 cut-off of 5.2 ng/mL, the sensitivity, specificity, PPV and NPV were 58.5, 95.5, 86.1, and 82.9% respectively. For proven sepsis, the cut-off of CRP 1 was 7.0 mg/L with a 76.5% sensitivity, 98.2% specificity, 94.9% PPV and 90.5% NPV (p < 0.001). At a PCT 1 cut-off of 1.36 ng/mL, the sensitivity, specificity, PPV and NPV were 90.8, 83.4, 70.6 and 94.4%, respectively (p < 0.001). In each subgroup, other than EONS, the performances of CRP 1 and PCT 1 measurements were found to be statistically higher than MPV 1. CRP 2 cut-off levels of LONS group and proven sepsis group were found to be lower than the initial values. Conclusions Optimal cut-off levels of CRP 1 and PCT 1 may differ in preterm sepsis subgroups. The diagnostic performances of CRP 1 and PCT 1 didn’t differ however, they were more efficacious than MPV. |
| first_indexed | 2024-12-20T14:45:17Z |
| format | Article |
| id | doaj.art-19c989e996b449c1ad0f41d49045dd8a |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-20T14:45:17Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-19c989e996b449c1ad0f41d49045dd8a2022-12-21T19:37:08ZengBMCBMC Pediatrics1471-24312018-08-0118111210.1186/s12887-018-1236-2The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsisC. Aydemir0H. Aydemir1F. Kokturk2C. Kulah3A. G. Mungan4Department of Pediatrics, Medical Faculty, Division of Neonatology, Bülent Ecevit UniversityDepartment of Infectious Diseases and Clinical Microbiology, Medical Faculty, Bulent Ecevit UniversityDepartment of Biostatistics, Medical Faculty, Bulent Ecevit UniversityDepartment of Microbiology, Medical Faculty, Bulent Ecevit UniversityDepartment of Biochemistry, Medical Faculty, Bulent Ecevit UniversityAbstract Background Sepsis is a leading cause of morbidity and mortality among newborns. C-reactive protein (CRP) and procalcitonin (PCT) have some limitations in the diagnosis of preterm neonatal sepsis. In this study, the cut-offs of PCT and CRP, and the efficacy of mean platelet volume (MPV) were investigated. Methods We identified key demographic details and compared laboratory values between preterm infants with early onset and late onset neonatal sepsis (EONS/LONS) retrospectively. Blood samples were collected within the first few hours of the onset of clinical sepsis (CRP 1, PCT 1, MPV 1) and were repeated after 24 h (CRP 2, PCT 2, MPV 2). The optimal cut-offs for CRP, PCT and MPV were determined using receiver operating characteristic (ROC) analysis. Furthermore, pairwise comparisons of ROC curves were made to evaluate the performances of these tests. Results In EONS, the cut-off of CRP 1 was 2.6 mg/L, the sensitivity, specificity, PPV and NPV were 80.6, 83.0, 67.5 and 90.7%, respectively (p < 0.001). At a PCT 1 cut-off of 1.1 ng/mL, the sensitivity, specificity, PPV and NPV were 78.6, 81.2, 64.7 and 89.6%, respectively (p < 0.001). The sensitivity, specificity, PPV, and NPV of the CRP 1 cut-off of 3.6 mg/L for LONS were 78.3, 87.4, 74.8, and 89.4%, respectively. At a PCT 1 cut-off of 5.2 ng/mL, the sensitivity, specificity, PPV and NPV were 58.5, 95.5, 86.1, and 82.9% respectively. For proven sepsis, the cut-off of CRP 1 was 7.0 mg/L with a 76.5% sensitivity, 98.2% specificity, 94.9% PPV and 90.5% NPV (p < 0.001). At a PCT 1 cut-off of 1.36 ng/mL, the sensitivity, specificity, PPV and NPV were 90.8, 83.4, 70.6 and 94.4%, respectively (p < 0.001). In each subgroup, other than EONS, the performances of CRP 1 and PCT 1 measurements were found to be statistically higher than MPV 1. CRP 2 cut-off levels of LONS group and proven sepsis group were found to be lower than the initial values. Conclusions Optimal cut-off levels of CRP 1 and PCT 1 may differ in preterm sepsis subgroups. The diagnostic performances of CRP 1 and PCT 1 didn’t differ however, they were more efficacious than MPV.http://link.springer.com/article/10.1186/s12887-018-1236-2Neonatal sepsisProcalcitoninCRPMPV |
| spellingShingle | C. Aydemir H. Aydemir F. Kokturk C. Kulah A. G. Mungan The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis BMC Pediatrics Neonatal sepsis Procalcitonin CRP MPV |
| title | The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| title_full | The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| title_fullStr | The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| title_full_unstemmed | The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| title_short | The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| title_sort | cut off levels of procalcitonin and c reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis |
| topic | Neonatal sepsis Procalcitonin CRP MPV |
| url | http://link.springer.com/article/10.1186/s12887-018-1236-2 |
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