Serum lactate and procalcitonin measurements in emergency room for the diagnosis and risk-stratification of patients with suspected infection

被引：33

作者：

Freund, Yonathan ^{[1
,2
]}

Delerme, Samuel ^{[1
]}

Goulet, Helene ^{[1
]}

Bernard, Maguy ^{[3
]}

Riou, Bruno ^{[1
,2
]}

Hausfater, Pierre ^{[1
,2
]}

机构：

[1] CHU Pitie Salpetriere, AP HP, Serv Accueil Urgences, Paris, France

[2] Univ Paris 06, Paris, France

[3] Univ Paris 05, Paris, France

来源：

BIOMARKERS | 2012年 / 17卷 / 07期

关键词：

Lactate; procalcitonin; sepsis; septic shock; diagnosis; prognosis; ED; C-REACTIVE PROTEIN; SEVERE SEPSIS; ORGAN FAILURE; NATRIURETIC PEPTIDE; DEPARTMENT PATIENTS; MORTALITY; CARE; CLEARANCE; MARKER; MULTICENTER;

D O I：

10.3109/1354750X.2012.704645

中图分类号：

Q81 [生物工程学（生物技术）]; Q93 [微生物学];

学科分类号：

071005 ; 0836 ; 090102 ; 100705 ;

摘要：

Objective: To study the contribution of lactate and procalcitonin (PCT) serum measurements for the diagnosis and the risk-stratification of patients with suspected infection presenting to the ED. Methods: Single-center one year observational study on 462 consecutive patients. Multivariate analysis to assess variables associated with sepsis, severe sepsis, septic shock and severe outcome. Results: Multivariate analysis (Odds ratio [95% CI]), showed that PCT was the best independent variable to identify sepsis (3.98 [2.60-6.10]), while lactate was the best to diagnose severe sepsis (10.88 [6.51-18.19]). Patients with both lactate above 2 mmol.L-1 and PCT above 0.8 ng.mL(-1) had an enhanced risk of severe outcome. Conclusions: the dosages of lactate and PCT are complementary for the diagnosis and risk-stratification of patients evaluated in the ED for suspected infection.

引用

页码：590 / 596

页数：7

共 30 条

[1] MULTICENTER STUDY OF EARLY LACTATE CLEARANCE AS A DETERMINANT OF SURVIVAL IN PATIENTS WITH PRESUMED SEPSIS [J].

Arnold, Ryan C. ;

Shapiro, Nathan I. ;

Jones, Alan E. ;

Schorr, Christa ;

Pope, Jennifer ;

Casner, Elisabeth ;

Parrillo, Joseph E. ;

Dellinger, R. Phillip ;

Trzeciak, Stephen .

SHOCK, 2009, 32 (01) :35-39

[2] HIGH SERUM PROCALCITONIN CONCENTRATIONS IN PATIENTS WITH SEPSIS AND INFECTION [J].

ASSICOT, M ;

GENDREL, D ;

CARSIN, H ;

RAYMOND, J ;

GUILBAUD, J ;

BOHUON, C .

LANCET, 1993, 341 (8844) :515-518

[3] Serial blood lactate levels can predict the development of multiple organ failure following septic shock [J].

Bakker, J ;

Gris, P ;

Coffernils, M ;

Kahn, RJ ;

Vincent, JL .

AMERICAN JOURNAL OF SURGERY, 1996, 171 (02) :221-226

[4] Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial [J].

Bouadma, Lila ;

Luyt, Charles-Edouard ;

Tubach, Florence ;

Cracco, Christophe ;

Alvarez, Antonio ;

Schwebel, Carole ;

Schortgen, Frederique ;

Lasocki, Sigismond ;

Veber, Benoit ;

Dehoux, Monique ;

Bernard, Maguy ;

Pasquet, Blandine ;

Regnier, Bernard ;

Brun-Buisson, Christian ;

Chastre, Jean ;

Wolff, Michel .

LANCET, 2010, 375 (9713) :463-474

[5] Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections:: cluster-randomised, single-blinded intervention trial [J].

Christ-Crain, M ;

Jaccard-Stolz, D ;

Bingisser, R ;

Gencay, MM ;

Huber, PR ;

Tamm, M ;

Müller, B .

LANCET, 2004, 363 (9409) :600-607

[6] Can C-reactive protein, procalcitonin and mid-regional pro-atrial natriuretic peptide measurements guide choice of in-patient or out-patient care in acute pyelonephritis? Biomarkers In Sepsis (BIS) multicentre study [J].

Claessens, Y-E. ;

Schmidt, J. ;

Batard, E. ;

Grabar, S. ;

Jegou, D. ;

Hausfater, P. ;

Kierzek, G. ;

Guerin, S. ;

Pourriat, J-L. ;

Dhainaut, J-F. ;

Ginsburg, C. .

CLINICAL MICROBIOLOGY AND INFECTION, 2010, 16 (06) :753-760

[7] Accuracy of C-reactive protein, procalcitonin, and mid-regional pro-atrial natriuretic peptide to guide site of care of community-acquired pneumonia [J].

Claessens, Yann-Erick ;

Mathevon, Thierry ;

Kierzek, Gerald ;

Grabar, Sophie ;

Jegou, David ;

Batard, Eric ;

Loyer, Clarisse ;

Davido, Alain ;

Hausfater, Pierre ;

Robert, Helene ;

Lavagna-Perez, Leila ;

Bernot, Bruno ;

Plaisance, Patrick ;

Leroy, Christophe ;

Renaud, Bertrand .

INTENSIVE CARE MEDICINE, 2010, 36 (05) :799-809

[8] Plasma procalcitonin and C-reactive protein in acute septic shock: Clinical and biological correlates [J].

Claeys, R ;

Vinken, S ;

Spapen, H ;

Elst, KV ;

Decochez, K ;

Huyghens, L ;

Gorus, FK .

CRITICAL CARE MEDICINE, 2002, 30 (04) :757-762

[9] Diagnostic and prognostic value of procalcitonin in patients with septic shock [J].

Clec'h, C ;

Ferriere, F ;

Karoubi, P ;

Fosse, JP ;

Cupa, M ;

Hoang, P ;

Cohen, Y .

CRITICAL CARE MEDICINE, 2004, 32 (05) :1166-1169

[10] COMPARING THE AREAS UNDER 2 OR MORE CORRELATED RECEIVER OPERATING CHARACTERISTIC CURVES - A NONPARAMETRIC APPROACH [J].

DELONG, ER ;

DELONG, DM ;

CLARKEPEARSON, DI .

BIOMETRICS, 1988, 44 (03) :837-845

← 1 2 3 →