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.
Procalcitonin (PCT) has shown some interest in infection diagnosis, early risk stratification and antibiotic therapy guidance. [1][2][3][4][5] Yet, no international consensus has guided its use until very recently for antibiotic (AB) stewardship (ABS), 6 making the prognosis indication of PCT unsupported. Lack of clarity regarding clinical algorithms applied in the emergency department (ED) has confused its prescrip-How to cite this article: De Ruffi S, Gornet M, Ramont L, et al. Analysis of 1635 procalcitonin prescriptions in the emergency department of a university hospital: A gap between evidence-based medicine and the real world?.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.