Files and links (1)
Accepted (AM)Open Access (License Unspecified), Open
Journal article
DISCRIMINATIVE VALUE OF INFLAMMATORY BIOMARKERS FOR SUSPECTED SEPSIS
The Journal of emergency medicine, v 43(1), pp 97-106
01 Jul 2012
PMID: 22056545
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Circulating biomarkers can facilitate sepsis diagnosis, enabling early management and improved outcomes. Procalcitonin (PCT) has been suggested to have superior diagnostic utility compared to other biomarkers. Study Objectives: To define the discriminative value of PCT, interleukin-6 (IL-6), and C-reactive protein (CRP) for suspected sepsis. Methods: PCT, CRP, and IL-6 were correlated with infection likelihood, sepsis severity, and septicemia. Multivariable models were constructed for length-of-stay and discharge to a higher level of care. Results: Of 336 enrolled subjects, 60% had definite infection, 13% possible infection, and 27% no infection. Of those with infection, 202 presented with sepsis, 28 with severe sepsis, and 17 with septic shock. Overall, 21% of subjects were septicemic. PCT, IL-6, and CRP levels were higher in septicemia (median PCT 2.3 vs. 0.2 ng/mL; IL-6 178 vs. 72 pg/mL; CRP 106 vs. 62 mg/dL; p < 0.001). Biomarker concentrations increased with likelihood of infection and sepsis severity. Using receiver operating characteristic analysis, PCT best predicted septicemia (0.78 vs. IL-6 0.70 and CRP 0.67), but CRP better identified clinical infection (0.75 vs. PCT 0.71 and IL-6 0.69). A PCT cutoff of 0.5 ng/mL had 72.6% sensitivity and 69.5% specificity for bacteremia, as well as 40.7% sensitivity and 87.2% specificity for diagnosing infection. A combined clinical-biomarker model revealed that CRP was marginally associated with length of stay (p = 0.015), but no biomarker independently predicted discharge to a higher level of care. Conclusions: In adult emergency department patients with suspected sepsis, PCT, IL-6, and CRP highly correlate with several infection parameters, but are inadequately discriminating to be used independently as diagnostic tools. (C) 2012 Published by Elsevier Inc.
Metrics
Details
- Title
- DISCRIMINATIVE VALUE OF INFLAMMATORY BIOMARKERS FOR SUSPECTED SEPSIS
- Creators
- Ephraim L. Tsalik - Duke UniversityL. Brett Jaggers - Duke UniversitySeth W. Glickman - University of North Carolina at Chapel HillRaymond J. Langley - National Center for Genome ResourcesJennifer C. van Velkinburgh - National Center for Genome ResourcesLawrence P. Park - Duke UniversityVance G. Fowler - Duke UniversityCharles B. Cairns - University of North Carolina at Chapel HillStephen F. Kingsmore - National Center for Genome ResourcesChristopher W. Woods - Duke University
- Publication Details
- The Journal of emergency medicine, v 43(1), pp 97-106
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- U19HD077693 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) 5U01-AI066569-5 / National Institutes of Health from National Institute of Allergy and Infectious Diseases Roche Molecular Sciences U01AI066569 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000306729100019
- Scopus ID
- 2-s2.0-84863992234
- Other Identifier
- 991021448045704721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Emergency Medicine