Clinical Use of Procalcitonin in the Diagnosis of Sepsis: Evaluation of PCT–qSOFA

다국어 초록 (Multilingual Abstract)

Background: Sepsis is a life-threatening medical condition, and the diagnosis of sepsis should be conducted rapidly and accurately. The purpose of this study was to evaluate the diagnostic performance of a combination of procalcitonin (PCT) levels and quick sequential organ failure assessment (qSOFA), namely PCT–qSOFA, for the diagnosis of sepsis.
Methods: A total of 204 patients were grouped according to the results of blood culture and systemic inflammatory response syndrome criteria (≥ 2/4) into the bacterial sepsis group (N = 67), the blood culture-negative sepsis group (N = 37), the blood culture-positive group without corresponding clinical symptoms or signs of sepsis (N = 35), and the control group without evidence of sepsis (N = 65). The diagnostic performance of PCT–qSOFA was assessed using the post-test probability analysis.
Results: Compared with qSOFA, PCT–qSOFA demonstrated improved post-test probability (from 0.772 to 0.884) and a positive likelihood ratio (from 1.59 to 3.55) when it was applied to all subjects, including those in the intensive care unit (ICU). However, this improvement in diagnostic performance was not observed when PCT–qSOFA was applied to patients outside the ICU.
Conclusions: The combined use of PCT and qSOFA can help clinicians identify patients with sepsis, including those in an ICU setting

참고문헌 (Reference)

1 Vincent JL, "qSOFA does not replace SIRS in the definition of sepsis" 20 : 210-, 2016

2 Michael Meisner, "Update on Procalcitonin Measurements" 대한진단검사의학회 34 (34): 263-273, 2014

3 Singer M, "The third international consensus definitions for sepsis and septic shock(Sepsis-3)" 315 : 801-810, 2016

4 Kaukonen KM, "Systemic infiammatory response syndrome criteria in defining severe sepsis" 372 : 1629-1638, 2015

5 Dellinger RP, "Surviving sepsis campaign : international guidelines for management of severe sepsis and septic shock : 2012" 41 : 580-637, 2013

6 Salomão R, "Sepsis: evolving concepts and challenges" 52 : e8595-, 2019

7 Simpson SQ, "SIRS in the time of Sepsis-3" 153 : 34-38, 2018

8 Spoto S, "Procalcitonin and MR-proadrenomedullin combination with SOFA and qSOFA scores for sepsis diagnosis and prognosis : a diagnostic algorithm" 50 : 44-52, 2018

9 Cortés-Puch I, "Opening the debate on the new sepsis definition change is not necessarily progress: revision of the sepsis definition should be based on new scientific insights" 194 : 16-18, 2016

10 Cortés-Puch I, "Opening the debate on the new sepsis definition change is not necessarily progress : revision of the sepsis definition should be based on new scientific insights" 194 : 16-18, 2016

11 Horan TC, "CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting" 36 : 309-332, 2008

12 Faix JD, "Biomarkers of sepsis" 50 : 23-36, 2013

13 Singh M, "Bedside procalcitonin and acute care" 4 : 233-237, 2014

14 "American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis" 20 : 864-874, 1992