Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients

Zhang, Hongmin; Wang, Xiaoting; Zhang, Qing; Xia, Ying; Liu, Dawei

doi:10.1186/s12877-017-0566-5

Cited by 29 publications

(24 citation statements)

References 33 publications

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“…On the other hand, in a total of 667 cases evaluated by Akagi et al, including 436 pneumonia cases aged 75 years and over, procalcitonin was not an independent predictor of mortality in the elderly and in the young group, but was associated with the severity of pneumonia 39 . In Zhang's study, when the cut-off value of procalcitonin was 0.250 ng/ml, the sensitivity and specificity were 88% and 65%, respectively 41 . This finding was consistent with our study.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Independent Prognostic Indicators in the Elderly with Pneumonia: A Single-Center Prospective Observational Study

Sürme

Balkan

Bayramlar

et al. 2019

Preprint

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Background: The aim of this study was to investigate poor prognostic indicators in the elderly with pneumonia. Methods: In this prospective observational study, the patients with pneumonia were stratified into younger (18-64 years) and older (≥65 years) groups. The poor prognostic indicators were determined and compared. Results: There were 184 pneumonia episodes in 155 patients. The median age of the cases was 72 (range, 18-104) of whom 127 (69%) were ≥65 years old and 110 (59.8%) were male. Mental status changes were more common in the elderly group (p=0.04). Multivariate regression analysis determined three variables that could be potential independent risk factors for poor prognosis in the elderly: dyspnea at the onset (OR:5.85, CI:5.18-6.52, p=0.01), previous antibiotic use within the last 3 months (OR:2.97, CI:2.51-3.43, p=0.02), acute renal failure (OR:2.51, CI:2.06-2.96, p=0.04). A receiver operating characteristic (ROC) analysis showed that the area under the curves (AUC) of procalcitonin and C-reactive protein (CRP) as indicators of poor prognosis in the elderly were 0.846 (p<0.001) and 0.650 (p=0.008) respectively. In addition, mental status changes (p<0.001), the confusion, blood urea nitrogen, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score (p<0.001), and the pneumonia severity index (PSI) (p<0.001) were associated with poor prognosis. Conclusion: Dyspnea at the onset, previous antibiotic use within the last 3 months, acute renal failure, serum CRP and procalcitonin levels along with the PSI and the CURB-65 scores should be carefully evaluated in terms of hospitalization, the need for intensive care unit admission and the initial antimicrobial therapy.

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Section: Discussionmentioning

confidence: 97%

“…In order to evaluate poor prognosis, the optimal cut-off value of CRP on D0 was 91.5 mg/L in the age-independent group, and 79 mg/L in the elderly group. In the study of 70 patients by Zhang et al, most of them were with pneumonia, examined the relationship of leukocyte, CRP and procalcitonin with sepsis/septic shock 41 .…”

Section: Discussionmentioning

confidence: 99%

Independent Prognostic Indicators in the Elderly with Pneumonia: A Single-Center Prospective Observational Study

Sürme

Balkan

Bayramlar

et al. 2019

Preprint

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“…Four papers focused on patients with speci c sepsis, such as patients with acute abdominal sepsis [37] , ventilator-associated pneumonia [47] , and postoperative sepsis [45,62] . Two articles addressed elderly patients with sepsis (aged > 65 [55] and > 85 years [60] ), whereas another study [52] included patients aged ≤ 65 and > 65 years. Two studies [18,33] reported separately cases of positive and negative blood cultures.…”

Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

Wang

Cong

et al. 2020

Preprint

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The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

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“…ProCT and CRP are the most preferable tests in sepsis [45]. Zhang et al [46] studied ProCT and high-sensitivity CRP (hs-CRP) levels in the evaluation of sepsis and septic shock in geriatric patients in the ICU. They found that hs-CRP and ProCT were good markers for the diagnosis of sepsis and septic shock in patients who were older than 85 years of age.…”

Section: Established and New Diagnostic Markers In Sepsis And Correlamentioning

confidence: 99%

Procalcitonin in the diagnosis of sepsis and its correlations with upcoming novel diagnostic markers

Sitar¹

2019

Int J Med Biochem

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INTERNATIONAL JOURNAL OF MEDICAL BIOCHEMISTRY Objectives: Sepsis is a complex and lethal condition. For successful treatment, clinicians need high quality testing to guide the approach to pathogen identification and treatment. Medical laboratories play a vital role in the detection of infectious agents, and must continually strive to discover new and reliable tests and to analyze the reliability of existing tests in different diseases and expand their usage as appropriate. Selecting the appropriate therapy, reducing the use of antibiotics and thereby reducing antibiotic resistance are also undeniable parts of this task. The most commonly used parameters to guide infection therapy are the white blood cell count, the erythrocyte sedimentation rate, the absolute count of neutrophils, the absolute number of lymphocytes, and the level of C-reactive protein, serum amyloid A protein, ceruloplasmin, haptoglobin, fibrinogen, and procalcitonin (ProCT). Although ProCT has been accepted as quite effective in differentiating serious bacterial infections, there are unresolved questions regarding effective usage during follow-up, as there are with other markers. ProCT and other promising biomarkers in a sepsis setting were the focus of this review, beginning with the first study to define ProCT in the literature, and examining some of the studies related to the importance of the ProCT-sepsis relationship, and detailed information on candidate markers.

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Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients

Cited by 29 publications

References 33 publications

Independent Prognostic Indicators in the Elderly with Pneumonia: A Single-Center Prospective Observational Study

Independent Prognostic Indicators in the Elderly with Pneumonia: A Single-Center Prospective Observational Study

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

Procalcitonin in the diagnosis of sepsis and its correlations with upcoming novel diagnostic markers

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