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首页> 外文期刊>European review for medical and pharmacological sciences. >Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases.
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Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases.

机译：急诊科入院后降钙素的变化可高度预测急性传染病患者的医院死亡率。

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摘要

To evaluate the diagnostic and prognostic usefulness of procalcitonin (PCT) in patients admitted to the Emergency Department (ED) with signs of infections and to assess the prognostic value of repeated measurements in predicting hospital mortality.A prospective, observational study was conducted in our 400-bed General Teaching Hospital. 261 patients arriving in ED with signs/symptoms of infection were enrolled. PCT was performed upon arrival in the ED (T0), and 5 days after antibiotic therapy (T5). Blood cultures were performed in all patients upon arrival in the ED.Mean T0 PCT value was 7.1±17.9 ng/ml, and at T5 3±9.1 ng/ml (p < 0.0001). Mean PCT in septic non-survivors was increased at T5 compared to T0 but not significantly. The PCT increase at T5 was an independent factor of mortality (OR = 1.29, p < 0.02) in septic patients. Compared to baseline mean delta % PCT decrease at T5 was 28%. Patients with a decrease delta % PCT > 28% showed a lower number of deaths, with a statistical significant difference if compared to those patients with a < 28% decrease (p < 0.004). ROC curve of delta % PCT for prediction of death has an AUC = 0.82 (p < 0.03).PCT is a useful marker for diagnosis of systemic and local infections, and for prognostic stratification in patients with acute infectious diseases at their arrival in ED. PCT variations after antibiotic therapy are highly predictive for in-hospital mortality. PCT normalization during antibiotic therapy suggests a good response to infection possibly leading to less infection-related deaths.
机译：为了评估降钙素（PCT）在急诊部（ED）有感染迹象的患者中的诊断和预后价值，并评估重复测量对预测医院死亡率的预后价值。我们对400名患者进行了一项前瞻性观察性研究。床的综合教学医院。纳入ED的261位有感染迹象/症状的患者。到达ED后（T0）和抗生素治疗后5天（T5）进行PCT。所有患者到达ED时均进行血培养，平均T0 PCT值为7.1±17.9 ng / ml，T5为3±9.1 ng / ml（p <0.0001）。与T0相比，在T5败血症非幸存者的平均PCT升高，但没有显着增加。在败血症患者中，T5时PCT升高是死亡率的独立因素（OR = 1.29，p <0.02）。与基线相比，在T5时PCT的平均增量百分比降低了28％。 PCT降低百分比％> 28％的患者死亡人数更低，与降低了<28％的患者相比，具有统计学显着性差异（p <0.004）。用于预测死亡的δ％PCT的ROC曲线的AUC = 0.82（p <0.03）。PCT是诊断全身和局部感染以及对到达ED的急性传染病患者进行预后分层的有用标记。抗生素治疗后的PCT变化可高度预测院内死亡率。抗生素治疗期间的PCT正常化表明对感染有良好的反应，可能导致更少的与感染相关的死亡。

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