Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission
Infectious biomarkers such as procalcitonin (PCT) can help overcome the lack of sensitivity of the quick Sequential Organ Failure Assessment (qSOFA) score for early identification of sepsis in emergency departments (EDs) and thus might be beneficial as point-of-care biomarkers in EDs. Our primary ai...
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/17/3869 |
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| author | Myrto Bolanaki Martin Möckel Johannes Winning Michael Bauer Konrad Reinhart Angelika Stacke Peter Hajdu Anna Slagman |
| author_facet | Myrto Bolanaki Martin Möckel Johannes Winning Michael Bauer Konrad Reinhart Angelika Stacke Peter Hajdu Anna Slagman |
| author_sort | Myrto Bolanaki |
| collection | DOAJ |
| description | Infectious biomarkers such as procalcitonin (PCT) can help overcome the lack of sensitivity of the quick Sequential Organ Failure Assessment (qSOFA) score for early identification of sepsis in emergency departments (EDs) and thus might be beneficial as point-of-care biomarkers in EDs. Our primary aim was to investigate the diagnostic performance of PCT for the early identification of septic patients and patients likely to develop sepsis within 96 h of admission to an ED among a prospectively selected patient population with elevated qSOFA score. In a large multi-centre prospective cohort study, we included all adult patients (<i>n</i> = 742) with a qSOFA score of at least 1 who presented to the ED. PCT levels were measured upon admission. Of the study population 27.3% (<i>n</i> = 202) were diagnosed with sepsis within the first 96 h. The area under the curve for PCT for the identification of septic patients in EDs was 0.86 (95% confidence interval (CI): 0.83–0.89). The resultant sensitivity for PCT at a cut-off of 0.5 µg/L was 63.4% (95% CI: 56.3–70.0). Furthermore, specificity was 89.2% (95% CI: 86.3–91.7), the positive predictive value was 68.8% (95% CI: 62.9–74.2), and the negative predictive value was 86.7% (95% CI: 84.4–88.7). The early measurement of PCT in a patient population with elevated qSOFA score served as an effective tool for the early identification of sepsis in ED patients. |
| first_indexed | 2024-03-10T08:10:17Z |
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| language | English |
| last_indexed | 2024-03-10T08:10:17Z |
| publishDate | 2021-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-f0e2e1de78f14afd90f7b049dbc975302023-11-22T10:48:44ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011017386910.3390/jcm10173869Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency AdmissionMyrto Bolanaki0Martin Möckel1Johannes Winning2Michael Bauer3Konrad Reinhart4Angelika Stacke5Peter Hajdu6Anna Slagman7Department of Emergency and Acute Medicine, Campus Virchow and Mitte, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Emergency and Acute Medicine, Campus Virchow and Mitte, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyKlinik für Anästhesiologie und Intensivmedizin, Uniklinikum Jena, Am Klinikum 1, 07747 Jena, GermanyKlinik für Anästhesiologie und Intensivmedizin, Uniklinikum Jena, Am Klinikum 1, 07747 Jena, GermanyKlinik für Anästhesiologie m. S. Operative Intensivmedizin, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyErnst-Abbe-Hochschule, University of Applied Sciences, Carl-Zeiss-Promenade 2, 07745 Jena, GermanyDepartment of Emergency and Acute Medicine, Campus Virchow and Mitte, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Emergency and Acute Medicine, Campus Virchow and Mitte, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyInfectious biomarkers such as procalcitonin (PCT) can help overcome the lack of sensitivity of the quick Sequential Organ Failure Assessment (qSOFA) score for early identification of sepsis in emergency departments (EDs) and thus might be beneficial as point-of-care biomarkers in EDs. Our primary aim was to investigate the diagnostic performance of PCT for the early identification of septic patients and patients likely to develop sepsis within 96 h of admission to an ED among a prospectively selected patient population with elevated qSOFA score. In a large multi-centre prospective cohort study, we included all adult patients (<i>n</i> = 742) with a qSOFA score of at least 1 who presented to the ED. PCT levels were measured upon admission. Of the study population 27.3% (<i>n</i> = 202) were diagnosed with sepsis within the first 96 h. The area under the curve for PCT for the identification of septic patients in EDs was 0.86 (95% confidence interval (CI): 0.83–0.89). The resultant sensitivity for PCT at a cut-off of 0.5 µg/L was 63.4% (95% CI: 56.3–70.0). Furthermore, specificity was 89.2% (95% CI: 86.3–91.7), the positive predictive value was 68.8% (95% CI: 62.9–74.2), and the negative predictive value was 86.7% (95% CI: 84.4–88.7). The early measurement of PCT in a patient population with elevated qSOFA score served as an effective tool for the early identification of sepsis in ED patients.https://www.mdpi.com/2077-0383/10/17/3869qSOFASOFAsepsisprocalcitonin |
| spellingShingle | Myrto Bolanaki Martin Möckel Johannes Winning Michael Bauer Konrad Reinhart Angelika Stacke Peter Hajdu Anna Slagman Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission Journal of Clinical Medicine qSOFA SOFA sepsis procalcitonin |
| title | Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission |
| title_full | Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission |
| title_fullStr | Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission |
| title_full_unstemmed | Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission |
| title_short | Diagnostic Performance of Procalcitonin for the Early Identification of Sepsis in Patients with Elevated qSOFA Score at Emergency Admission |
| title_sort | diagnostic performance of procalcitonin for the early identification of sepsis in patients with elevated qsofa score at emergency admission |
| topic | qSOFA SOFA sepsis procalcitonin |
| url | https://www.mdpi.com/2077-0383/10/17/3869 |
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