The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients Characteristics and Clinical History
2.2. Procalcitonin Sampling and Group Definition
2.3. Outcome Measures
2.4. Statistical Analysis and Chart Review Methodology
3. Results
3.1. Study Cohort
3.2. Early PCT Determination and In-Hospital Death
3.3. LOS and Early PCT Determination
4. Discussion
Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total Patients 12,062 pts | qSOFA < 2 11,136 pts | qSOFA ≥ 2 826 pts |
---|---|---|---|
Sex (Male) | 6644 (55.1%) | 6206 (55.2%) | 438 (53.0) |
Age (years) | 71 (55–81) | 70 (54–81) | 78 (67–85) |
Temperature °C | 37.9 (37.0–38.8) | 37.8 (36.9–38.7) | 38.2 (37.5–39.1) |
Heart Rate (b/min) | 95 (80–110) | 95 (80–110) | 99 (83–114) |
Systolic Blood Pressure (mmHg) | 127 (110–145) | 130 (114–145) | 100 (90–110) |
Diastolic Blood Pressure (mmHg) | 70 (60–80) | 71 (61–81) | 60 (50–76) |
Peripheral SaO2 | 95 (92–97) | 95 (92–97) | 94 (89–96) |
Procalcitonin in Emergency Department | 3402 (28.2%) | 3022 (26.9%) | 380 (46.0%) |
Blood Culture in Emergency Department | 2261 (18.7%) | 1991 (17.7%) | 270 (32.7%) |
Charlson score ≥ 2 | 3244 (26.9%) | 3010 (26.8%) | 234 (28.3%) |
Outcomes | |||
Infectious diagnosis (any) ‡ | 7437 (61.7) | 6844 (60.9%) | 593 (71.8%) |
| 4525 (37.5) | 4177 (37.2%) | 348 (42.1%) |
| 919 (7.6%) | 778 (6.9%) | 141 (17.1%) |
| 3066 (25.4%) | 2844 (25.3%) | 222 (26.9%) |
LOS # (days) | 10 (6–17) | 10 (6–17) | 11 (7–18) |
Deceased | 1533 (12.7%) | 1337 (11.9%) | 196 (23.7%) |
Controls n 8860 | Ealry PCT n 3402 | p Value | |
All patients | 1070/8660 (12.4%) | 463/3402 (13.6%) | 0.063 |
qSOFA < 2 | Controls n 8214 | Early PCT n 3022 | p Value |
All patients | 952/8214 (11.6%) | 385/3022 (12.7%) | 0.095 |
Infectious diagnosis (any) | 568/4831 (11.7%) | 251/2013 (12.5%) | 0.381 |
| 459/3073 (14.9%) | 174/1104 (15.8%) | 0.512 |
| 142/464 (30.6%) | 66/248 (21.0%) | 0.003 |
| 136/1974 (6.9%) | 77/870 (8.9%) | 0.067 |
qSOFA ≥ 2 | Controls n 446 | Early PCT n 380 | p Value |
All patients | 118/446 (26.5%) | 78/380 (20.5%) | 0.046 |
Infectious diagnosis (any) | 80/322 (24.8%) | 55/271 (20.3%) | 0.188 |
| 66/218 (30.3%) | 44/130 (33.8%) | 0.488 |
| 25/62 (40.3%) | 25/79 (31.6%) | 0.285 |
| 13/100 (13.0%) | 10/122 (8.2%) | 0.243 |
Controls n 8860 | Early PCT n 3402 | p Value | ||
All Population | 10 (6–17) | 11 (7–18) | <0.001 | |
qSOFA < 2 | Controls n 8214 | Early PCT n 3022 | p Value | |
All patients | 10 (6–17) | 11 (7–18) | <0.001 | |
Infectious disease diagnosis (any) | 10 (6–17) | 11 (7–18) | <0.001 | |
qSOFA ≥ 2 | Controls n 446 | Ealry PCT n 380 | p Value | |
All patients | 10 (7–17) | 11 (7–19) | 0.044 | |
Infectious disease diagnosis (any) | 11 (7–17) | 11 (7–19) | 0.136 |
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Covino, M.; Gallo, A.; Montalto, M.; De Matteis, G.; Burzo, M.L.; Simeoni, B.; Murri, R.; Candelli, M.; Ojetti, V.; Franceschi, F. The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever. Medicina 2021, 57, 179. https://doi.org/10.3390/medicina57020179
Covino M, Gallo A, Montalto M, De Matteis G, Burzo ML, Simeoni B, Murri R, Candelli M, Ojetti V, Franceschi F. The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever. Medicina. 2021; 57(2):179. https://doi.org/10.3390/medicina57020179
Chicago/Turabian StyleCovino, Marcello, Antonella Gallo, Massimo Montalto, Giuseppe De Matteis, Maria Livia Burzo, Benedetta Simeoni, Rita Murri, Marcello Candelli, Veronica Ojetti, and Francesco Franceschi. 2021. "The Role of Early Procalcitonin Determination in the Emergency Departiment in Adults Hospitalized with Fever" Medicina 57, no. 2: 179. https://doi.org/10.3390/medicina57020179