균혈증의 조기 발견을 위한 Procalcitonin/Albumin Ratio와 Blood Urea Nitrogen/Albumin Ratio의 임상적 유용성 = Clinical usefulness of procalcitonin/albumin and blood urea nitrogen/albumin ratios for the early detection of bacteremia

다국어 초록 (Multilingual Abstract)

Background: Early prediction of bacteremia is important because sepsis may develop ifbacteremia is not treated in time. We aimed to determine whether blood tests are clinicallyuseful in predicting gram-negative versus gram-positive bacteremia.
Methods: We retrospectively analyzed the medical records of 16,569 patients who underwentblood culture testing among those who visited St. Mary’s Hospital of Uijeongbu, CatholicUniversity from January 1, 2018 to December 31, 2018. After excluding 15,580 patients withinsufficient data for analysis, the total study population was 989.
Results: In the multivariable logistic regression analysis for gram-negative bacteremia, afteradjusting for major variables, procalcitonin (odds ratio [OR] 1.02, P < 0.001), high-sensitivityC-reactive protein (OR 1.03, P = 0.010), and albumin (OR 0.55, P = 0.010) were significant. Inthe same model, lactic acid (OR 1.08, P = 0.010), blood urea nitrogen (BUN) (OR 1.02, P =0.010), and albumin (OR 0.50, P = 0.005) were significant for gram-positive bacteremia.
We constructed blood indicators by combining blood tests that were significant inmultivariable logistic regression analysis. Comparing the area under the curve (AUC) of thereceiver operating characteristic curve, the AUC of the procalcitonin/albumin ratio in gramnegativebacteremia was significantly higher than that of procalcitonin (0.846 vs. 0.837, P =0.005), and the AUC of the BUN/albumin ratio in gram-positive bacteremia was significantlyhigher than that of BUN (0.709 vs. 0.679, P = 0.007).
Conclusion: The procalcitonin/albumin ratio is expected to be helpful in the early predictionof gram-negative bacteremia, whereas the BUN/albumin ratio in the early prediction of grampositivebacteremia.