Anemia measurements to distinguish between viral and bacterial infections in the emergency department

Steuerman, Yael; Wasserman, Asaf; Zeltser, David; Shapira, Itzhak; Trotzky, Daniel; Halpern, Pinchas; Meilik, Ahuva; Raykhshtat, Eli; Berliner, Shlomo; Rogowski, Ori; Gat‐Viks, Irit; Shenhar‐Tsarfaty, Shani

doi:10.1007/s10096-019-03682-0

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…A caveat remains for patients with heart failure, as the increase of volemia subsequent to a blood transfusion may cause a worsening of their cardiac function. Furthermore, in infective cases [38] with a high prevalence of anemia, the iron sequestration of bacteria from human tissues is a well-known phenomenon [39,40] to the point that in the emergency settings the severity of anemia has been suggested to differentiate between viral and bacterial infections [41]. Thus, in these situations the treatment of anemia has been questioned, as iron and blood transfusions should facilitate bacterial growth and activity.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Causes of Anemia in Hospitalized Patients: Impact on Diseases Outcome

Randi

Bertozzi

Sommer

et al. 2020

JCM

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Anemia is extremely common in hospitalized patients who are old and often with multiple diseases. We evaluated 435 consecutive patients admitted in the internal medicine department of a hub hospital and 191 (43.9%) of them were anemic. Demographic, historic and clinical data, laboratory tests, duration of hospitalization, re-admission at 30 days and death were recorded. Patients were stratified by age (<65, 65–80, >80 years), anemia severity, and etiology of anemia. The causes of anemia were: iron deficiency in 28 patients, vitamin B12 and folic acid deficiencies in 6, chronic inflammatory diseases in 80, chronic kidney disease in 15, and multifactorial in 62. The severity of the clinical picture at admission was significantly worse (p < 0.001), length of hospitalization was longer (p < 0.001) and inversely correlated to the Hb concentration, re-admissions and deaths were more frequent (p 0.017) in anemic compared to non-anemic patients. A specific treatment for anemia was used in 99 patients (36.6%) (transfusions, erythropoietin, iron, vitamin B12 and/or folic acid). Anemia (and/or its treatment) was red in the discharge letter only 54 patients. Even if anemia is common, in internal medicine departments scarce attention is paid to it, as it is generally considered a “minor” problem, particularly in older patients often affected by multiple pathologies. Our data indicate the need of renewed medical attention to anemia, as it may positively affect the outcome of several concurrent medical conditions and the multidimensional loss of function in older hospitalized patients.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Causes of Anemia in Hospitalized Patients: Impact on Diseases Outcome

Randi

Bertozzi

Sommer

et al. 2020

JCM

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“…RDW is a predictor associated with mortality in critical illness patients and higher in non-survival burn patients group and different time trends [ 10 ]. RDW also has the potential power of predicting morbidity, mortality of infectious disease, and sepsis [ 11 ]. Few studies have reported on the predictive power for mortality in burn patients.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal profile of routine biomarkers for mortality prediction using unsupervised clustering algorithm in severely burned patients: a retrospective cohort study with prospectively collected data

et al. 2023

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Purpose Burn injury has high clinical heterogeneity and worse prognosis in severely burned patients. Clustering algorithms using unsupervised methods to identify groups with similar trajectories in heterogeneous disease patients can provide insight into mechanisms of disease pathogenesis. This study analyzed routinely collected biomarkers to evaluate mortality prediction, find clinical meanings for these or their subtypes, and evaluate patterns. Methods This retrospective cohort study included patients aged >18 years, between July 2012 and June 2021. All eligible patients received fluid resuscitation and survived for at least 7 days. Characteristics of clinical interest to the physician at 4 clinically important time points were evaluated. Results Eligible patients were divided into 4 subgroups according to these time points: from 1st week to 4th week. Total of 1,249 patients admitted within 2 days after burns and receiving fluid resuscitation were included. Mean Harrell’s C-index of pH was the highest (0.816), followed by platelets (0.807), creatinine (0.796), red cell distribution width (RDW, 0.778), and lactate (0.759). Longitudinal profiles among biomarkers were different. Conclusion The main predictors were pH, platelets, creatinine, RDW, and lactate. Creatinine and RDW showed consistent patterns. The other markers varied according to patient condition. Thus, these markers could provide clues into underlying mechanisms and predict mortality.

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“…[ 36 ] In more recent studies, in a retrospective study in emergency departments, no significant difference was found in CRP levels between viral and bacterial infections (63.84 [0–526.7] vs. 65.12 [0–526.7], P > 0.05). [ 37 ]…”

Section: C-reactive Proteinmentioning

confidence: 99%

Use of infection biomarkers in the emergency department

Özger

Senol

2022

Turk J Emerg Med

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The use of infection biomarkers in the emergency department is discussed in terms of their possible contributions to diagnostic-prognostic uncertainties, appropriate antibiotic treatments, and triage and follow-up planning. Procalcitonin (PCT), C-reactive protein (CRP), proadrenomedullin (proADM), and presepsin are among the most discussed infection biomarkers for use in the emergency department. Due to the variable sensitivity results and cutoff values, there are insufficient data to recommend the widespread use of CRP and procalcitonin (PCT) for the diagnosis and prognosis of infection in the emergency department. However, these biomarkers can be used for appropriate antibiotic use in selected infection groups, such as community-acquired pneumonia, especially to reduce unnecessary antibiotic prescribing. With its prognostic superiority over other biomarkers and its contribution to prognostic score systems in community-acquired pneumonia (CAP), proADM can be used to predict hospitalization, preferably within the scope of clinical studies. Although presepsin has been shown to have some advantages over other biomarkers to rule out sepsis, there are insufficient data for its clinical use in the emergency department.

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Anemia measurements to distinguish between viral and bacterial infections in the emergency department

Cited by 4 publications

References 26 publications

Prevalence and Causes of Anemia in Hospitalized Patients: Impact on Diseases Outcome

Prevalence and Causes of Anemia in Hospitalized Patients: Impact on Diseases Outcome

Longitudinal profile of routine biomarkers for mortality prediction using unsupervised clustering algorithm in severely burned patients: a retrospective cohort study with prospectively collected data

Use of infection biomarkers in the emergency department

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