Impact of Previous Sepsis on Procalcitonin Accuracy for Blood Stream Infection Diagnosis
Author Information
Author(s): Charles Pierre Emmanuel, Ladoire Sylvain, Snauwaert Aurélie, Prin Sébastien, Aho Serge, Pechinot André, Olsson Niels-Olivier, Blettery Bernard, Doise Jean-Marc, Quenot Jean-Pierre
Primary Institution: Service de Réanimation Médicale, Hôpital Le Bocage, C.H.U. de Dijon, France
Hypothesis
The pattern of procalcitonin (PCT) elevation is different in critically ill patients who experienced secondary sepsis compared to those with a first episode of infection.
Conclusion
In critically ill patients with blood stream infection, procalcitonin elevation and diagnostic accuracy are lower if sepsis is secondary compared to those with a first episode of infection.
Supporting Evidence
- Procalcitonin levels were significantly lower in patients with secondary sepsis compared to those with primary sepsis.
- The area under the receiver-operating characteristic curve for PCT was lower in secondary sepsis patients.
- A low PCT value was independently associated with secondary sepsis.
Takeaway
Doctors use a test called procalcitonin to help find infections in very sick patients, but it doesn't work as well if the patient has had an infection before.
Methodology
A review of medical records of patients with blood stream infection who had procalcitonin dosage available.
Potential Biases
Potential biases due to the retrospective design and differences in timing of PCT measurements.
Limitations
The study is retrospective, which may introduce confounding variables, and PCT dosing may not have been performed within the same time frame in both groups.
Participant Demographics
Patients admitted to a 15-bed medical ICU, with 117 episodes of primary sepsis and 62 episodes of secondary sepsis.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 0.699–0.879
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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