Clinical Outcome Predictive Value of Procalcitonin in Patients Suspected with Infection in the Emergency Department.
Fiche publication
Date publication
janvier 2021
Journal
Emergency medicine international
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RAMONT Laurent
Tous les auteurs :
Leroux P, De Ruffi S, Ramont L, Gornet M, Giordano Orsini G, Losset X, Kanagaratnam L, Gennai S
Lien Pubmed
Résumé
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.
Référence
Emerg Med Int. 2021 ;2021:2344212