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Titolo:
Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis
Autore:
Harbarth, S; Holeckova, K; Froidevaux, C; Pittet, D; Ricou, B; Grau, GE; Vadas, L; Pugin, J;
Indirizzi:
Univ Hosp Geneva, Div Med Intens Care, CH-1211 Geneva 14, Switzerland UnivHosp Geneva Geneva Switzerland 14 e, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva, Lab Cent Chim Clin, CH-1211 Geneva, Switzerland Univ Hosp Geneva Geneva Switzerland CH-1211 CH-1211 Geneva, Switzerland Univ Hosp Geneva, Dept Pathol, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva Geneva Switzerland 14 l, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva, Div Surg Intens Care, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva Geneva Switzerland 14 e, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva, Div Infect Dis, CH-1211 Geneva 14, Switzerland Univ HospGeneva Geneva Switzerland 14 s, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva, Infect Control Program, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva Geneva Switzerland 14 m, CH-1211 Geneva 14, Switzerland
Titolo Testata:
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 3, volume: 164, anno: 2001,
pagine: 396 - 402
SICI:
1073-449X(20010801)164:3<396:DVOPIA>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
C-REACTIVE PROTEIN; INFLAMMATORY RESPONSE SYNDROME; NECROSIS-FACTOR-ALPHA; INTENSIVE-CARE UNIT; SEPTIC SHOCK; PLASMA-CONCENTRATIONS; SERUM PROCALCITONIN; ACUTE-PANCREATITIS; INFECTED NECROSIS; PREDICTION;
Keywords:
critical care; biological markers, blood; calcitonin, blood; protein precursors, blood; interleukin-6, blood; interleukin-8, blood; sepsis, blood, diagnosis; sepsis syndrome, blood, diagnosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Pugin, J Univ Hosp Geneva, Div Med Intens Care, CH-1211 Geneva 14, Switzerland Univ Hosp Geneva Geneva Switzerland 14 1 Geneva 14, Switzerland
Citazione:
S. Harbarth et al., "Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis", AM J R CRIT, 164(3), 2001, pp. 396-402

Abstract

To assess the diagnostic value of procalcitonin (PCT), interleukin (IL)-6,IL-8, and standard measurements in identifying critically ill patients with sepsis, we performed prospective measurements in 78 consecutive patients admitted with acute systemic inflammatory response syndrome (SIRS) and suspected infection. We estimated the relevance of the different parameters by using multivariable regression modeling, likelihood-ratio tests, and area under the receiver operating characteristic curves (AUC). The final diagnosis was SIRS, in 18 patients, sepsis in 14, severe sepsis in 21, and septic shock in 25. PCT yielded the highest discriminative value, with an AUC of 0.92 (CI, 0.85 to 1.0), followed by IL-6 (0.75; CI, 0.63 to 0.87), and IL-8 (0.71; CI, 0.59 to 0.83; p < 0.001). At a cutoff of 1.1 ng/ml, PCT yielded asensitivity of 97% and a specificity of 78% to differentiate patients withSIRS from those with sepsis-related conditions. Median PCT concentrations on admission (ng/ mi, range) were 0.6 (0 to 5.3) for SIRS; 3.5 (0.4 to 6.7)for sepsis; 6.2 (2.2 to 85) for severe sepsis; and 21.3 (1.2 to 654) for septic shock (p < 0.001). The addition of PCT to a model based solely on standard indicators improved the predictive power of detecting sepsis (likelihood ratio test; p = 0.001) and increased the AUC value for the routine value-based model from 0.77 (CI, 0.64 to 0.89) to 0.94 (CI, 0.89 to 0.99; p = 0.002). In contrast, no additive effect was seen for IL-6 (p = 0.56) or IL-8(p = 0. 14). Elevated PCT concentrations appear to be a promising indicator of sepsis in newly admitted, critically ill patients capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 11:58:16