A novel procalcitonin-based score for detecting sepsis among critically ill patients

doi:10.1371/journal.pone.0245748

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23328

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23328

Title:	A novel procalcitonin-based score for detecting sepsis among critically ill patients
Authors:	Tsui, TL;Huang, YT;Kan, WC;Huang, MS;Lai, MY;Ueng, KC;Shiao, CC
Date:	2021
Issue Date:	2022-08-05T09:35:31Z (UTC)
Publisher:	PUBLIC LIBRARY SCIENCE
ISSN:	1932-6203
Abstract:	Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9 +/- 16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, serum PCT level, albumin level and neutrophil-lymphocyte ratio at ICU admission, along with diabetes mellitus, and with vasopressor. We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74-0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2 +/- 16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69-0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.
URI:	http://dx.doi.org/10.1371/journal.pone.0245748 https://www.webofscience.com/wos/woscc/full-record/WOS:000612929300071 https://ir.csmu.edu.tw:8080/handle/310902500/23328
Relation:	PLOS ONE ,2021,v16,issue 1
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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