Diagnostic and prognostic value of procalcitonin in patients with septic shock

Clec’h, Christophe; Ferrière, Françoise; Karoubi, Philippe; Fosse, Jean-Philippe; Cupa, M; Hoang, P.; Cohen, Yves

doi:10.1097/01.ccm.0000126263.00551.06

Cited by 195 publications

(133 citation statements)

References 24 publications

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“…Future research may thus need to focus on scores that combine laboratory data, vital signs, trends in data, 31,32 and newer proteomic markers (eg, procalcitonin). 33 We also found that most transfers occurred early (within <72 hours), raising the possibility that at least some of these transfers may involve issues around triage rather than sudden deterioration. Our study has important limitations.…”

Section: Discussionmentioning

confidence: 90%

Intra‐hospital transfers to a higher level of care: Contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)

Escobar¹,

Greene²,

Gardner³

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Patients who experience intra‐hospital transfers to a higher level of care (eg, ward to intensive care unit [ICU]) are known to have high mortality. However, these findings have been based on single‐center studies or studies that employ ICU admissions as the denominator.OBJECTIVE:To employ automated bed history data to examine outcomes of intra‐hospital transfers using all hospital admissions as the denominator.DESIGN:Retrospective cohort study.SETTING:A total of 19 acute care hospitals.PATIENTS:A total of 150,495 patients, who experienced 210,470 hospitalizations, admitted to these hospitals between November 1st, 2006 and January 31st, 2008.MEASUREMENTS:Predictors were age, sex, admission type, admission diagnosis, physiologic derangement on admission, and pre‐existing illness burden; outcomes were: 1) occurrence of intra‐hospital transfer, 2) death following admission to the hospital, 3) death following transfer, and 4) total hospital length of stay (LOS).RESULTS:A total of 7,868 hospitalizations that began with admission to either a general medical surgical ward or to a transitional care unit (TCU) had at least one transfer to a higher level of care. These hospitalizations constituted only 3.7% of all admissions, but accounted for 24.2% of all ICU admissions, 21.7% of all hospital deaths, and 13.2% of all hospital days. Models based on age, sex, preadmission laboratory test results, and comorbidities did not predict the occurrence of these transfers.CONCLUSIONS:Patients transferred to higher level of care following admission to the hospital have excess mortality and LOS. Journal of Hospital Medicine 2010;. © 2010 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 90%

Intra‐hospital transfers to a higher level of care: Contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)

Escobar¹,

Greene²,

Gardner³

et al. 2010

Journal of Hospital Medicine

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show abstract

“…A recent metaanalysis (Simon et al 2004) evaluating 12 studies that simultaneously compared CRP and PCT levels for the diagnosis of bacterial infection in hospitalized patients, showed that PCT levels were more sensitive (88 vs 75%) and also more specific (81 vs 67%) than CRP levels to distinguish bacterial from non-bacterial inflammation. However, few studies evaluated the prognostic accuracy of these markers, and when this was done the discriminative performance for prognosis of PCT and PCR was poor (Clec'h et al 2004). As a general conclusion, these studies show that CRP and PCT are useful biomarkers for diagnosis in septic patients but, although they are regarded as markers of systemic inflammation, higher levels are usually seen in patients with bacterial infection than inpatients with SIRS or viral infection.…”

Section: Biomarkers Are Essential For Stratification Of Septic Patientsmentioning

confidence: 98%

Beyond sepsis pathophysiology with cytokines: what is their value as biomarkers for disease severity?

Bozza

Neto

2005

Mem. Inst. Oswaldo Cruz

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“…In study done by Christophe Clec'h et al, found that serum PCT on day 1 was significantly higher in patients with septic shock than those with sepsis. On addition among patients with sepsis, PCT concentrations were significantly higher in those who died than in the survivors at all four measurement time points [20]. Also in prognostic assessment of sepsis, PCT value was found to correlate significantly with the acute and both procalcitonin and s TREM-1 but it was more positive for the later in the prediction of the severity of illness.…”

Section: Discussionmentioning

confidence: 83%

The Role of TREM-1 Gene Expression and Soluble TREM-1 as Prognostic Markers of Sepsis

Atef¹,

Ghonaim²

2016

J Med Microb Diagn

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Background: Determination of TREM-1 expression on monocytes has been investigated as a perspective diagnostic method to distinguish infectious from non-infectious etiology of the inflammation. Objectives:To analyse the expression of the TREM-1 gene in patients of sepsis and septic shock and its relation with the severity of pathophysiological conditions. Also to describe the dynamics changes of soluble TREM-1, procalcitonin and C-reactive protein during the course of sepsis and Correlation between their expressions and the clinical scoring system known as APACHE II scoring system. Material and Methods:After an ethical approval, the expression of mRNA of TREM-1 in PMNs was detected in 76 critically ill patients (49 with sepsis and 27 with septic shock) were analyzed by using quantitative real-time PCR. The concentration of s. TREM-1, CRP and PCT levels were measured by an enzyme immunoassay. Results:On the ICU admission, the septic shock group displayed higher levels of sTREM-1, PCT, APACHE II score (P<0.001) and CRP (P=0.01) than the sepsis group. Significant positive correlation (P<0.05) between APACHE II and both sTREM-1 and PCT in the prognosis of morbidity were shown. The mRNA levels of patients suffering from sepsis and septic shock were 0.54-and 0.39-fold lower compared to those of healthy subjects (1.06) respectively. Conclusion:With regard to sepsis diagnosis and severity, sTREM-1 and PCT have positive values in prognostic assessment of the disease and may be taken as a survival-impacting risk factor. The TREM-1 gene expression levels isolated from patients with sepsis may be used as a surrogate marker for determining the severity.

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Diagnostic and prognostic value of procalcitonin in patients with septic shock

Abstract: These data indicate that procalcitonin may be a valuable early diagnostic and prognostic marker in patients with septic shock.

Cited by 195 publications

References 24 publications

Intra‐hospital transfers to a higher level of care: Contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)

Intra‐hospital transfers to a higher level of care: Contribution to total hospital and intensive care unit (ICU) mortality and length of stay (LOS)

Beyond sepsis pathophysiology with cytokines: what is their value as biomarkers for disease severity?

The Role of TREM-1 Gene Expression and Soluble TREM-1 as Prognostic Markers of Sepsis

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