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Utility of procalcitonin as a predictor of bloodstream infections and supportive modality requirements in critically ill cancer patients.
Blouin, Amanda G; Hsu, Meier; Fleisher, Martin; Ramanathan, Lakshmi V; Pastores, Stephen M.
Afiliación
  • Blouin AG; Center for Laboratory Medicine, New York, NY, United States. Electronic address: blouina@mskcc.org.
  • Hsu M; Department of Epidemiology and Biostatistics, New York, NY, United States.
  • Fleisher M; Center for Laboratory Medicine, New York, NY, United States.
  • Ramanathan LV; Center for Laboratory Medicine, New York, NY, United States.
  • Pastores SM; Critical Care Center Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Clin Chim Acta ; 510: 181-185, 2020 Nov.
Article en En | MEDLINE | ID: mdl-32679129
ABSTRACT

BACKGROUND:

We evaluated the diagnostic utility of procalcitonin (PCT) in predicting bacterial bloodstream infections (BSI) in critically ill cancer patients with and without neutropenia. We also investigated the role of PCT as a prognostic marker of supportive modalities (vasopressors, invasive mechanical ventilation, and renal replacement therapy (RRT)) in the intensive care unit (ICU).

METHODS:

We retrospectively analyzed 2200 PCT and blood cultures from adult cancer patients with suspected sepsis. Primary outcome was BSI, defined by positive blood culture, collected within 72 h of PCT collection.

RESULTS:

Median PCT values were higher in encounters with BSI (3.2 vs 0.5 ng/ml, p < 0.001). The area under the ROC curve (AUC) was 0.726 (95%CI 0.698, 0.754). PCT > 2.0 ng/ml was significantly associated with greater likelihood of BSI and this effect was significantly stronger for neutropenic (OR 9.09, 95%CI 4.39, 18.79) compared with non-neutropenic patients (OR 4.00 (95% CI 3.13, 5.10), interaction p = 0.036). PCT > 2.0 was associated with vasopressor requirement on ICU admission (OR 1.82 (95% CI 1.31, 2.53), p < 0.001) and RRT (OR 2.20 (95% CI 1.24, 3.91), p = 0.007).

CONCLUSIONS:

Procalcitonin is a fair discriminator of BSI in critically ill cancer patients with and without neutropenia and a PCT > 2.0 ng/ml was significantly more likely to require vasopressors and RRT in the ICU.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Neoplasias Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Clin Chim Acta Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Neoplasias Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Clin Chim Acta Año: 2020 Tipo del documento: Article