Utility of procalcitonin in a medical intensive care unit in Croatia
Summary Aims To investigate the clinical benefit of routine procalcitonin (PCT) measurement in the medical intensive care unit (ICU) of a tertiary referral hospital. Methods Adult patients with suspected infections were included. White blood cells, C‑reactive protein (CRP), and PCT were measured. Re...
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| Veröffentlicht in: | Wiener Klinische Wochenschrift 2021-08, Vol.133 (15-16), p.832-839 |
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| creator | Vujaklija Brajković, Ana Košuta, Iva Tomek, Dora Rora, Mia Babel, Jakša Rogić, Dunja Lončar Vrančić, Ana Radonić, Radovan |
| description | Summary
Aims
To investigate the clinical benefit of routine procalcitonin (PCT) measurement in the medical intensive care unit (ICU) of a tertiary referral hospital.
Methods
Adult patients with suspected infections were included. White blood cells, C‑reactive protein (CRP), and PCT were measured.
Results
In this study 129 patients of median age 64 years (interquartile range 39–89 years) were prospectively included. The Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 21 ± 14 and 7 ± 6, respectively. Intensive care unit (ICU) mortality was 22.5%. Immunocompromised patients constituted 39.5%. A significant correlation was observed between PCT and APACHE II (Spearman’s rho 0.461,
p
|
| doi_str_mv | 10.1007/s00508-020-01747-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7538271</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2449181150</sourcerecordid><originalsourceid>FETCH-LOGICAL-c446t-46e77f7c741a65864ac65e18e1bd7a998d0e2759be3a9a5e784bad06326341373</originalsourceid><addsrcrecordid>eNp9kEtqHDEQhkVwiCdOLuCF6aU3nVTp2b0xmMF5gCGbeC00mhpHpkcaS2qDb5Oz5GTRZBzjbAICoapfXxUfY6cIHxDAfCwACoYeOPSARpoeX7EFahS90QaP2AJAil4Jro7Z21LuAISSBt-wYyGAK66GBbu6qWEK9bFLm26Xk3eTDzXFELt23K-fW1qHVmyvSrGEB-q8y9TNMdR9YpmTq8G9Y683bir0_uk-YTefrr4vv_TX3z5_XV5e915KXXupyZiN8Uai02rQ0nmtCAfC1dq4cRzWQNyocUXCjU6RGeTKrUELroVEYcQJuzhwd_OqbeYp1uwmu8th6_KjTS7Yfzsx_LC36cEaJQZusAHOnwA53c9Uqt2G4mmaXKQ0F8ulHHFAVNCi_BD1OZWSafM8BsHu_duDf9v82z_-7Z5_9nLB5y9_hbeAOARKa8VbyvYuzTk2af_D_gbKP5Go</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2449181150</pqid></control><display><type>article</type><title>Utility of procalcitonin in a medical intensive care unit in Croatia</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Vujaklija Brajković, Ana ; Košuta, Iva ; Tomek, Dora ; Rora, Mia ; Babel, Jakša ; Rogić, Dunja ; Lončar Vrančić, Ana ; Radonić, Radovan</creator><creatorcontrib>Vujaklija Brajković, Ana ; Košuta, Iva ; Tomek, Dora ; Rora, Mia ; Babel, Jakša ; Rogić, Dunja ; Lončar Vrančić, Ana ; Radonić, Radovan</creatorcontrib><description>Summary
Aims
To investigate the clinical benefit of routine procalcitonin (PCT) measurement in the medical intensive care unit (ICU) of a tertiary referral hospital.
Methods
Adult patients with suspected infections were included. White blood cells, C‑reactive protein (CRP), and PCT were measured.
Results
In this study 129 patients of median age 64 years (interquartile range 39–89 years) were prospectively included. The Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 21 ± 14 and 7 ± 6, respectively. Intensive care unit (ICU) mortality was 22.5%. Immunocompromised patients constituted 39.5%. A significant correlation was observed between PCT and APACHE II (Spearman’s rho 0.461,
p
< 0.01), PCT and SOFA (Spearman’s rho 0.494,
p
< 0.01) and PCT and CRP (Spearman’s rho 0.403,
p
< 0.01). Most patients (
n
= 83, 64.3%) received antibiotics before admission. No difference in PCT (1.56 ± 8 µg/L vs. 1.44 ± 13 µg/L,
p
= 0.6) was observed with respect to previous antibiotic therapy. Levels of PCT and CRP were significantly increased in patients with positive blood cultures, the infection caused by Gram-negative microorganism regardless of disease severity and pneumonia with complications. PCT did not differ among patients with positive vs negative urine culture (4.6 ± 16 µg/L vs. 1.76 ± 11.9 µg/L) or positive vs. negative endotracheal aspirate (1.93 ± 11.4 µg/L vs. 1.76 ± 1.11 µg/L). PCT-guided stewardship was applied in 36 patients (28%).
Conclusion
Increased initial PCT levels might point to the development of more severe disease caused by Gram-negative bacteria, regardless of previous antibiotic treatment. The results pertain to immunocompetent and immunocompromised patients. Implementation of PCT-guided stewardship in those patients is possible and relies on experience as well as knowledge of reference change value for a marker within the specific setting.</description><identifier>ISSN: 0043-5325</identifier><identifier>EISSN: 1613-7671</identifier><identifier>DOI: 10.1007/s00508-020-01747-1</identifier><identifier>PMID: 33025258</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Croatia - epidemiology ; Endocrinology ; Gastroenterology ; Humans ; Intensive Care Units ; Internal Medicine ; Medicine ; Medicine & Public Health ; Middle Aged ; Original ; Original Article ; Pneumology/Respiratory System ; Procalcitonin ; Prognosis ; ROC Curve ; Sepsis</subject><ispartof>Wiener Klinische Wochenschrift, 2021-08, Vol.133 (15-16), p.832-839</ispartof><rights>Springer-Verlag GmbH Austria, part of Springer Nature 2020</rights><rights>2020. Springer-Verlag GmbH Austria, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-46e77f7c741a65864ac65e18e1bd7a998d0e2759be3a9a5e784bad06326341373</citedby><cites>FETCH-LOGICAL-c446t-46e77f7c741a65864ac65e18e1bd7a998d0e2759be3a9a5e784bad06326341373</cites><orcidid>0000-0002-9374-429X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00508-020-01747-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00508-020-01747-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33025258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vujaklija Brajković, Ana</creatorcontrib><creatorcontrib>Košuta, Iva</creatorcontrib><creatorcontrib>Tomek, Dora</creatorcontrib><creatorcontrib>Rora, Mia</creatorcontrib><creatorcontrib>Babel, Jakša</creatorcontrib><creatorcontrib>Rogić, Dunja</creatorcontrib><creatorcontrib>Lončar Vrančić, Ana</creatorcontrib><creatorcontrib>Radonić, Radovan</creatorcontrib><title>Utility of procalcitonin in a medical intensive care unit in Croatia</title><title>Wiener Klinische Wochenschrift</title><addtitle>Wien Klin Wochenschr</addtitle><addtitle>Wien Klin Wochenschr</addtitle><description>Summary
Aims
To investigate the clinical benefit of routine procalcitonin (PCT) measurement in the medical intensive care unit (ICU) of a tertiary referral hospital.
Methods
Adult patients with suspected infections were included. White blood cells, C‑reactive protein (CRP), and PCT were measured.
Results
In this study 129 patients of median age 64 years (interquartile range 39–89 years) were prospectively included. The Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 21 ± 14 and 7 ± 6, respectively. Intensive care unit (ICU) mortality was 22.5%. Immunocompromised patients constituted 39.5%. A significant correlation was observed between PCT and APACHE II (Spearman’s rho 0.461,
p
< 0.01), PCT and SOFA (Spearman’s rho 0.494,
p
< 0.01) and PCT and CRP (Spearman’s rho 0.403,
p
< 0.01). Most patients (
n
= 83, 64.3%) received antibiotics before admission. No difference in PCT (1.56 ± 8 µg/L vs. 1.44 ± 13 µg/L,
p
= 0.6) was observed with respect to previous antibiotic therapy. Levels of PCT and CRP were significantly increased in patients with positive blood cultures, the infection caused by Gram-negative microorganism regardless of disease severity and pneumonia with complications. PCT did not differ among patients with positive vs negative urine culture (4.6 ± 16 µg/L vs. 1.76 ± 11.9 µg/L) or positive vs. negative endotracheal aspirate (1.93 ± 11.4 µg/L vs. 1.76 ± 1.11 µg/L). PCT-guided stewardship was applied in 36 patients (28%).
Conclusion
Increased initial PCT levels might point to the development of more severe disease caused by Gram-negative bacteria, regardless of previous antibiotic treatment. The results pertain to immunocompetent and immunocompromised patients. Implementation of PCT-guided stewardship in those patients is possible and relies on experience as well as knowledge of reference change value for a marker within the specific setting.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Croatia - epidemiology</subject><subject>Endocrinology</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Original Article</subject><subject>Pneumology/Respiratory System</subject><subject>Procalcitonin</subject><subject>Prognosis</subject><subject>ROC Curve</subject><subject>Sepsis</subject><issn>0043-5325</issn><issn>1613-7671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtqHDEQhkVwiCdOLuCF6aU3nVTp2b0xmMF5gCGbeC00mhpHpkcaS2qDb5Oz5GTRZBzjbAICoapfXxUfY6cIHxDAfCwACoYeOPSARpoeX7EFahS90QaP2AJAil4Jro7Z21LuAISSBt-wYyGAK66GBbu6qWEK9bFLm26Xk3eTDzXFELt23K-fW1qHVmyvSrGEB-q8y9TNMdR9YpmTq8G9Y683bir0_uk-YTefrr4vv_TX3z5_XV5e915KXXupyZiN8Uai02rQ0nmtCAfC1dq4cRzWQNyocUXCjU6RGeTKrUELroVEYcQJuzhwd_OqbeYp1uwmu8th6_KjTS7Yfzsx_LC36cEaJQZusAHOnwA53c9Uqt2G4mmaXKQ0F8ulHHFAVNCi_BD1OZWSafM8BsHu_duDf9v82z_-7Z5_9nLB5y9_hbeAOARKa8VbyvYuzTk2af_D_gbKP5Go</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Vujaklija Brajković, Ana</creator><creator>Košuta, Iva</creator><creator>Tomek, Dora</creator><creator>Rora, Mia</creator><creator>Babel, Jakša</creator><creator>Rogić, Dunja</creator><creator>Lončar Vrančić, Ana</creator><creator>Radonić, Radovan</creator><general>Springer Vienna</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9374-429X</orcidid></search><sort><creationdate>20210801</creationdate><title>Utility of procalcitonin in a medical intensive care unit in Croatia</title><author>Vujaklija Brajković, Ana ; Košuta, Iva ; Tomek, Dora ; Rora, Mia ; Babel, Jakša ; Rogić, Dunja ; Lončar Vrančić, Ana ; Radonić, Radovan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-46e77f7c741a65864ac65e18e1bd7a998d0e2759be3a9a5e784bad06326341373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Croatia - epidemiology</topic><topic>Endocrinology</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Original Article</topic><topic>Pneumology/Respiratory System</topic><topic>Procalcitonin</topic><topic>Prognosis</topic><topic>ROC Curve</topic><topic>Sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vujaklija Brajković, Ana</creatorcontrib><creatorcontrib>Košuta, Iva</creatorcontrib><creatorcontrib>Tomek, Dora</creatorcontrib><creatorcontrib>Rora, Mia</creatorcontrib><creatorcontrib>Babel, Jakša</creatorcontrib><creatorcontrib>Rogić, Dunja</creatorcontrib><creatorcontrib>Lončar Vrančić, Ana</creatorcontrib><creatorcontrib>Radonić, Radovan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Wiener Klinische Wochenschrift</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vujaklija Brajković, Ana</au><au>Košuta, Iva</au><au>Tomek, Dora</au><au>Rora, Mia</au><au>Babel, Jakša</au><au>Rogić, Dunja</au><au>Lončar Vrančić, Ana</au><au>Radonić, Radovan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of procalcitonin in a medical intensive care unit in Croatia</atitle><jtitle>Wiener Klinische Wochenschrift</jtitle><stitle>Wien Klin Wochenschr</stitle><addtitle>Wien Klin Wochenschr</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>133</volume><issue>15-16</issue><spage>832</spage><epage>839</epage><pages>832-839</pages><issn>0043-5325</issn><eissn>1613-7671</eissn><abstract>Summary
Aims
To investigate the clinical benefit of routine procalcitonin (PCT) measurement in the medical intensive care unit (ICU) of a tertiary referral hospital.
Methods
Adult patients with suspected infections were included. White blood cells, C‑reactive protein (CRP), and PCT were measured.
Results
In this study 129 patients of median age 64 years (interquartile range 39–89 years) were prospectively included. The Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 21 ± 14 and 7 ± 6, respectively. Intensive care unit (ICU) mortality was 22.5%. Immunocompromised patients constituted 39.5%. A significant correlation was observed between PCT and APACHE II (Spearman’s rho 0.461,
p
< 0.01), PCT and SOFA (Spearman’s rho 0.494,
p
< 0.01) and PCT and CRP (Spearman’s rho 0.403,
p
< 0.01). Most patients (
n
= 83, 64.3%) received antibiotics before admission. No difference in PCT (1.56 ± 8 µg/L vs. 1.44 ± 13 µg/L,
p
= 0.6) was observed with respect to previous antibiotic therapy. Levels of PCT and CRP were significantly increased in patients with positive blood cultures, the infection caused by Gram-negative microorganism regardless of disease severity and pneumonia with complications. PCT did not differ among patients with positive vs negative urine culture (4.6 ± 16 µg/L vs. 1.76 ± 11.9 µg/L) or positive vs. negative endotracheal aspirate (1.93 ± 11.4 µg/L vs. 1.76 ± 1.11 µg/L). PCT-guided stewardship was applied in 36 patients (28%).
Conclusion
Increased initial PCT levels might point to the development of more severe disease caused by Gram-negative bacteria, regardless of previous antibiotic treatment. The results pertain to immunocompetent and immunocompromised patients. Implementation of PCT-guided stewardship in those patients is possible and relies on experience as well as knowledge of reference change value for a marker within the specific setting.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>33025258</pmid><doi>10.1007/s00508-020-01747-1</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9374-429X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Croatia - epidemiology Endocrinology Gastroenterology Humans Intensive Care Units Internal Medicine Medicine Medicine & Public Health Middle Aged Original Original Article Pneumology/Respiratory System Procalcitonin Prognosis ROC Curve Sepsis |
| title | Utility of procalcitonin in a medical intensive care unit in Croatia |
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