Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study
Bacteremia is associated with significant morbidity and mortality. Timely, appropriate therapy may improve clinical outcomes, and therefore, determining which patients benefit from more comprehensive diagnostic strategies (i.e., direct specimen testing) could be of value. We performed an assessment...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/20/3174 |
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| author | Tristan T. Timbrook Cherilyn D. Garner Kyle D. Hueth Gerald A. Capraro Louise Zimmer Hari P. Dwivedi |
| author_facet | Tristan T. Timbrook Cherilyn D. Garner Kyle D. Hueth Gerald A. Capraro Louise Zimmer Hari P. Dwivedi |
| author_sort | Tristan T. Timbrook |
| collection | DOAJ |
| description | Bacteremia is associated with significant morbidity and mortality. Timely, appropriate therapy may improve clinical outcomes, and therefore, determining which patients benefit from more comprehensive diagnostic strategies (i.e., direct specimen testing) could be of value. We performed an assessment of procalcitonin (PCT) and clinical characteristics in the discrimination of bacteremic hospitalizations. We analyzed 71,105 encounters and 14,846 visits of patients with bacteremia alongside 56,259 without an admission. The area under the receiver—operating characteristic (AUROC) curve for the prediction of bacteremia via procalcitonin was 0.782 (95% CI 0.779–0.787). The prediction modeling of clinical factors with or without PCT resulted in a similar performance to PCT alone. However, the clinically predicted risk of bacteremia stratified by PCT thresholds allowed the targeting of high-incidence bacteremia groups (e.g., ≥50% positivity). The combined use of PCT and clinical characteristics could be useful in diagnostic stewardship by targeting further advanced diagnostic testing in patients with a high predicted probability of bacteremia. |
| first_indexed | 2024-03-10T21:19:33Z |
| format | Article |
| id | doaj.art-535d662b02484bbfa682be67944577ff |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T21:19:33Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-535d662b02484bbfa682be67944577ff2023-11-19T16:12:19ZengMDPI AGDiagnostics2075-44182023-10-011320317410.3390/diagnostics13203174Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational StudyTristan T. Timbrook0Cherilyn D. Garner1Kyle D. Hueth2Gerald A. Capraro3Louise Zimmer4Hari P. Dwivedi5BioMérieux, Salt Lake City, UT 84104, USABioMérieux, Salt Lake City, UT 84104, USABioMérieux, Salt Lake City, UT 84104, USABioMérieux, Salt Lake City, UT 84104, USABioMérieux, Salt Lake City, UT 84104, USABioMérieux, Salt Lake City, UT 84104, USABacteremia is associated with significant morbidity and mortality. Timely, appropriate therapy may improve clinical outcomes, and therefore, determining which patients benefit from more comprehensive diagnostic strategies (i.e., direct specimen testing) could be of value. We performed an assessment of procalcitonin (PCT) and clinical characteristics in the discrimination of bacteremic hospitalizations. We analyzed 71,105 encounters and 14,846 visits of patients with bacteremia alongside 56,259 without an admission. The area under the receiver—operating characteristic (AUROC) curve for the prediction of bacteremia via procalcitonin was 0.782 (95% CI 0.779–0.787). The prediction modeling of clinical factors with or without PCT resulted in a similar performance to PCT alone. However, the clinically predicted risk of bacteremia stratified by PCT thresholds allowed the targeting of high-incidence bacteremia groups (e.g., ≥50% positivity). The combined use of PCT and clinical characteristics could be useful in diagnostic stewardship by targeting further advanced diagnostic testing in patients with a high predicted probability of bacteremia.https://www.mdpi.com/2075-4418/13/20/3174procalcitonindiagnosticsrisk factorsbloodstream infectionblood culture |
| spellingShingle | Tristan T. Timbrook Cherilyn D. Garner Kyle D. Hueth Gerald A. Capraro Louise Zimmer Hari P. Dwivedi Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study Diagnostics procalcitonin diagnostics risk factors bloodstream infection blood culture |
| title | Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study |
| title_full | Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study |
| title_fullStr | Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study |
| title_full_unstemmed | Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study |
| title_short | Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study |
| title_sort | procalcitonin and risk prediction for diagnosing bacteremia in hospitalized patients a retrospective national observational study |
| topic | procalcitonin diagnostics risk factors bloodstream infection blood culture |
| url | https://www.mdpi.com/2075-4418/13/20/3174 |
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