The Correlation between Infection Probability Score and Procalcitonin in Emergency Department Patients.
- Author:
Gyu Dong JO
1
;
Pil Cho CHOI
;
Sang Kuk HAN
;
Dong Hyuk SHIN
;
Hyun Jung LEE
;
Ji Ung NA
Author Information
1. Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. jiung.na@samsung.com
- Publication Type:Original Article
- Keywords:
Bacterial infections;
Procalcitonin;
Predictive Value of Tests
- MeSH:
Adult;
Bacterial Infections;
Biomarkers;
Diagnosis;
Emergencies*;
Hematologic Tests;
Humans;
Intensive Care Units;
Linear Models;
Predictive Value of Tests;
Retrospective Studies;
ROC Curve;
Sensitivity and Specificity
- From:Journal of the Korean Society of Emergency Medicine
2013;24(6):694-701
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Procalcitonin is a well-established biochemical marker for bacterial infection. We conducted this study to analyze the correlation between procalcitonin and Infection Probability Score (IPS), a recently introduced scoring system to predict bacterial infection in intensive care unit patients. The cutoff value of IPS corresponding to procalcitonin cutoff values was determined for procalcitonin-guided antibiotic therapy in emergency department (ED) patients. METHODS: A retrospective observation study was conducted on adult ED patients who simultaneously underwent an IPS-required blood test and procalcitonin treatment from January 1, 2012 to June 30, 2012. Based on their diagnosis at discharge, patients were grouped into a lower respiratory infection group or an "other" diagnosis group. The correlation between IPS and procalcitonin was analyzed by correlation and linear regression analysis. The IPS value corresponded to 0.25 ng/mL procalcitonin (in the lower respiratory infection group) and 0.5 ng/mL (in the other diagnosis group) as inferred by ROC curve analysis. A total of 722 cases (lower respiratory infection group: 258, other diagnosis group: 464) were included in the final analysis. RESULTS: In correlation analysis, the IPS showed a significant correlation with procalcitonin level in both groups (r=0.26, p<0.01, r=0.25, p<0.01, respectively). In ROC curve analysis, IPS 14 could predict procalcitonin> or =0.25 microg/L in the lower respiratory infection group (area under curve: 0.783 [95% CI, 0.724-0.841], sensitivity: 77.8%, specificity: 72.3%). Also, IPS 14 could predict procalcitonin> or =0.5 microg/L in the other diagnosis group (area under curve: 0.764 [95% CI, 0.717-0.810], sensitivity: 70.1%, specificity: 74.2%). CONCLUSION: The IPS had a significant correlation with procalcitonin level and IPS> or =14 corresponded to the procalcitonin cut-off value to predict bacterial infection in ED patients. Thus, IPS> or =14 may be used to predict bacterial infection and can guide early anti-microbial therapy in ED patients when procalcitonin is not readily available.
