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Valuable prognostic indicators for severe burn sepsis with inhalation lesion:age, platelet count, and procalcitonin

Burns & Trauma 2018年第4期6卷 255-261页

作者： Yichao Xu Xinyuan Jin Xiaonan Shao Feng Zheng Hong Zhou Department of Burns Fujian Medical University Union HospitalFuzhou 350000China Department of Burn Plastic Surgery The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou 215008China Department of Nuclear Medicine The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China Department of Critical Care Medicine The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China Department of Plastic Surgery and Burns The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China

Background:Severe burn sepsis can lead to high mortality. We explored the valuable prognostic indicators for severe burn sepsis with inhalation lesion. Methods:Thirty-eight severe burn patients with sepsis who were admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2017 were retrospectively analyzed. Among them, 22 patients were assigned to the death group and 16 patients to the survival group. Their general information, vital signs, and blood index including serum procalcitonin (PCT) and C-reactive protein (CRP) levels at admission, diagnosis of sepsis, and 1-week post-diagnosis of sepsis were compared. Results:Patients in the death group were older and had lower platelet count (PLT) at diagnosis of sepsis and 1-week post-diagnosis as well as higher PCT level at 1-week post-diagnosis than patients in the survival group (all p<0.05). According to receiver operating characteristic (ROC) curves, the above four indicators could be used to predict the prognosis, and the area under the curve (AUC) of PLT at diagnosis and 1-week post-diagnosis was larger (0.888 and 0.911), and PLT at diagnosis had the highest sensitivity and specificity (0.842 and 0.937). In addition, these patients were divided into two groups by the optimal cutoff age of 38 years. According to multivariate logistic regression analysis and COX regression analysis, only age group and PLT at diagnosis were statistically significant (all p<0.05). The risk of death in the older group was 28 times higher than that in the younger group, and the risk of death increased by 3%for each unit reduction in PLT at diagnosis. Moreover, age group was an independent factor affecting the patients' survival (β=?1.370, p=0.026). Considering the survival time after sepsis, the mortality risk was lower for patients in the older group than for patients in the younger group (hazard ratio (HR)=0.254, 95%confidence interval (CI) 0.076–0.851). Conclusion:Age, PLT at diagnosis of sepsis, an

关键词： Burns Sepsis Age Platelet count procalcitonin

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Diagnostic performance of Neutrophil CD64 index,procalcitonin,and C-reactive protein for early sepsis in hematological patients

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World Journal of Clinical Cases 2022年第7期10卷 2127-2137页

作者： Yu-Xi Shang Zhi Zheng Min Wang Hui-Xia Guo Yi-Juan Chen Yue Wu Xing Li Qian Li Jian-Ying Cui Xiao-Xiao Ren Li-Ru Wang Department of Hematology Fuxing HospitalEighth Clinical Medical CollegeCapital Medical UniversityBeijing 100038China Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China

BACKGROUND Patients with hematological diseases are immunosuppressed due to various factors,including the disease itself and treatments,such as chemotherapy and immunotherapy,and are susceptible to *** in these patients often progress rapidly to sepsis,which is *** To evaluate the diagnostic efficacy of the neutrophil CD64(nCD64)index,compared to procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP),for the identification of early sepsis in patients with hematological *** This was a prospective analysis of patients with hematological diseases treated at the Fuxing Hospital affiliated with Capital Medical University,between March 2014 and December *** nCD64 index was quantified by flow cytometry and the Leuko64 assay *** factors which may affect the nCD64 index levels were compared between patients with different infection statuses(local infection,sepsis,and no infection),and the control group and the nCD64 index levels were compared among the *** diagnostic efficacy of the nCD64 index,PCT,and hs-CRP for early sepsis was evaluated among patients with hematological *** A total of 207 patients with hematological diseases(non-infected group,n=50;locally infected group,n=67;sepsis group,n=90)and 26 healthy volunteers were *** to the absolute neutrophil count(ANC),patients with hematological diseases without infection were divided into the normal ANC,ANC reduced,and ANC deficiency *** was no statistically significant difference in the nCD64 index between these three groups(P=0.586).However,there was a difference in the nCD64 index among the non-infected(0.74±0.26),locally infected(1.47±1.10),and sepsis(2.62±1.60)groups(P<0.001).The area under the diagnosis curve of the nCD64 index,evaluated as the difference between the sepsis and locally infected group,0.777,which was higher than for PCT(0.735)and hs-CRP(0.670).The positive and negative likelihood ratios w

关键词： CD64 index Hematological diseases Sepsis procalcitonin C-reactive protein

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Combining Serum procalcitonin Level,Thromboelastography,and Platelet Count to Predict Short-term Development of Septic Shock in Intensive Care Unit

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Current Medical Science 2023年第1期43卷 86-92页

作者： Xue-song ZHAO Zhao-li MENG Tuo ZHANG Hong-na YANG Ji-cheng ZHANG Wei FANG Chun-ting WANG Man CHEN Department of Critical Care Medicine Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan250021China Department of Critical Care Medicine Shandong Provincial HospitalCheeloo College of MedicineShandong UniversityJinan250021China The First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital) Jinan250021China

Objective Despite the recent advances in diagnosis and treatment,sepsis continues to lead to high morbidity and *** diagnosis and prompt treatment are essential to save ***,most biomarkers can only help to diagnose sepsis,but cannot predict the development of septic shock in high-risk *** present study determined whether the combined measurement of procalcitonin(PCT),thromboelastography(TEG)and platelet(PLT)count can predict the development of septic *** A retrospective study was conducted on 175 septic patients who were admitted to the intensive care unit between January 2017 and February *** patients were divided into two groups:73 patients who developed septic shock were assigned to the septic shock group,while the remaining 102 patients were assigned to the sepsis ***,the demographic,clinical and laboratory data were recorded,and the predictive values of PCT,TEG and PLT count for the development of septic shock were *** Compared to the sepsis group,the septic shock group had statistically lower PLT count and TEG measurements in the R value,K value,αangle,maximum amplitude,and coagulation index,but had longer prothrombin time(DT),longer activated partial thromboplastin time(APTT),and higher PCT ***,the Sequential Organ Failure Assessment(SOFA)score was higher in the septic shock *** multivariate logistic regression analysis revealed that PCT,TEG and PLT count were associated with the development of septic *** area under the curve analysis revealed that the combined measurement of PCT,TEG and PLT count can be used to predict the development of septic shock with higher accuracy,when compared to individual *** The combined measurement of PCT,TEG and PLT count is a novel approach to predict the development of septic shock in high-risk patients.

关键词： sepsis shock thromboelastography procalcitonin platelet

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Significance of Fractional Exhaled Nitric Oxide Combined with Serum procalcitonin and C-Reactive Protein in Evaluation of Elderly Asthma

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第2期33卷 185-188页

作者：吴纪珍马利军赵丽敏张晓宇陈献亮况红艳 Department of Respiratory Medicine and Intensive Care Union the People's Hospital of Henan Province

Bronchial asthma is a common chronic airway inflammatory disease. Asthma is associated with high mortality, especially in the elderly patients. Repeated exacerbations cause disease progression. Therefore, identifying the onset of acute elderly asthma as soon as possible and giving the effective treatment is crucial to improve the prognosis. This study was to investigate the significance of fractional exhaled nitric oxide （FeNO） combined with serum procalcitonin （PCT） and C-reactive protein （CRP） in the evaluation of elderly asthma. A total of 120 elderly patients with an acute attack of asthma from July, 2010 to May, 2012 were studied. On presentation, FeNO, serum PCT and CRP concentrations were measured and sputum culture was also performed. The elderly patients were re-evaluated when they had returned to their stable clinical state. The elderly patients were classified into two groups： positive bac- terial culture group （A） and negative bacterial culture group （B）. The results showed that：（1） In patients with an acute exacerbation of asthma, 48 （40%） patients had positive sputum bacterial culture and 72 （60%） had negative sputum bacterial culture. （2） The levels of FeNO in patients with acute exacerbation of asthma were significantly higher than in those with no acute exacerbation state （63.8±24.6 vs. 19±6.5 ppb, P〈0.05）. There was no significant difference in FeNO between group A and group B （P〉0.05）. （3） The levels of PCT and CRP in group A patients with an acute exacerbation of asthma were significantly higher （P〈0.05） than in group B （for PCT： 27.46±9.32 vs. 7.85±3.52 ng/mL; for CRP： 51.25±11.46 vs. 17.11±5.87 mg/L, respectively）. When they had returned to stable clinical state, the levels of PCT and CRP in group A were decreased significantly （P〈0.05）, and those in group B had no significant change （P〉0.05） when compared with the exacerbation group. There were no significant differences in the levels of PCT and CRP between the two groups in non-acute exacerb

关键词： elderly asthma fractional exhaled nitric oxide procalcitonin C-reactive protein bacterial infection

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Incidental diagnosis of medullary thyroid carcinoma due to persistently elevated procalcitonin in a patient with COVID-19 pneumonia:A case report

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World Journal of Clinical Cases 2022年第20期10卷 7171-7177页

作者： Amitabha Saha Madhusha Mukhopadhyay Souvik Paul Arnab Bera Tapas Bandyopadhyay Department of Internal Medicine Critical Care MedicineMedica Superspecialty HospitalKolkata 700099West BengalIndia Department of Internal Medicine Medica Superspecialty HospitalKolkata 700099West BengalIndia Department of Critical Care Medicine Medica Superspecialty HospitalKolkata 700099West BengalIndia

BACKGROUND procalcitonin(Pct)is a common biomarker in clinical practice,especially in the era of coronavirus disease 2019(COVID-19)*** it is frequently used for the diagnosis and prognostication of bacterial infections or sepsis,it is also elevated in a few other conditions,including medullary thyroid carcinoma(MTC).CASE SUMMARY A 43-year-old female presented with moderately severe COVID-19 pneumonia in April *** gradually recovered clinically;however,despite normalization of other inflammatory markers,Pct levels remained persistently *** workup identified the cause as left lobe MTC with locoregional *** levels were high,and carcinoembryonic antigen levels were *** patient underwent total thyroidectomy and neck dissection,which was followed by another radical neck dissection due to residual ***,she is doing well,nearly having completed her course of external beam radiotherapy with no *** is well documented as a screening tool for MTC,especially because of its stable nature compared to calcitonin in the community *** is important to keep in mind the differential diagnosis of MTC in patients with persistently elevated Pct levels despite normal levels of other acute phase *** the best of our knowledge,this is the first report from Asia of such an incidental diagnosis of MTC due to persistently elevated Pct levels in a patient with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)*** Persistently elevated Pct levels can occur in any pro-inflammatory state including infections,sepsis,or acute respiratory distress *** the current setting,SARS-CoV-2 infection is one such clinical scenario,and in rare situations of persistent elevation,MTC may need to be ruled out.

关键词： COVID-19 Medullary thyroid carcinoma procalcitonin SARS-COV-2 Calcitonin Case report

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Clinical importance of serum procalcitonin in ulcerative colitis patients

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World Journal of Gastroenterology 2014年第42期20卷 15941-15942页

作者： Ergenekon Karagoz Alpaslan Tanoglu Department of Infectious Diseases and Clinical Microbiology GATA Haydarpasa Training Hospital Department of Gastroenterology GATA Haydarpasa Training Hospital

We have read with interest the recently published article entitled “Clinical significance of serum procalcitonin in patients with ulcerative colitis” by Koido et al. They aimed to investigate the association of procalcitonin with ulcerative colitis (UC) activity. They concluded that elevated procalcitonin levels were significantly correlated with UC activity. We would like to thank the authors for their comprehensive contribution.

关键词： procalcitonin Ulcerative colitis Clinical significance Disease activity Remission phase

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Value of inflammatory mediator profiles and procalcitonin in predicting postoperative infection in patients with hypertensive cerebral hemorrhage

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World Journal of Clinical Cases 2022年第35期10卷 12936-12945页

作者： Rang-Hua Yin Bin Zhang Xing-He Zhou Lu-Ping Cao Ming Li Department of Surgery Ji’an City Hospital of Traditional Chinese MedicineJi’an 343000Jiangxi ProvinceChina

BACKGROUND Hypertensive cerebral hemorrhage(HICH)is a common clinical cerebrovascular disease and one of the most serious complications of *** warning of the occurrence of infection during treatment and timely anti-infective treatment are of great significance for the early prevention and treatment of postoperative infection in patients with *** in the levels of inflammatory mediators,which are closely related to the occurrence and development of postoperative infection,and procalcitonin(PCT),which is a sensitive indicator for diagnosing bacterial infections,are widely used in clinical *** To explore the application value of inflammatory mediator profiles and PCT in predicting postoperative infection in patients with *** A total of 271 patients who underwent HICH surgery at our hospital between March 2019 and March 2021 were selected and divided into the infection(n=80)and non-infection(n=191)groups according to whether postoperative infection *** postoperative infection status and etiological characteristics of the infective pathogens in the infection group were *** in inflammatory mediator profile indices and PCT levels were compared between the two groups,pre-and *** A total of 109 strains of pathogenic bacteria were detected in the infection group,including 67 strains(61.47%)of gram-negative bacteria,32 strains(29.36%)of gram-positive bacteria,and 10 strains(9.17%)of *** main infection site of the patients in the infection group was the respiratory system(63.75%).Preoperative interleukin(IL)-4,IL-6,IL-10,tumor necrosis factor-α,interferon-γ,and PCT levels were higher in the infection group than in the non-infection group(P0.05).The inflammatory mediator profile indices and PCT levels were higher in the two groups of patients on the first postoperative day than preoperatively(P<0.05)

关键词： Hypertensive cerebral hemorrhage Postoperative infection Inflammatory mediator profiles procalcitonin Prediction Immune function

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Diagnostic significance of serum levels of serum amyloid A,procalcitonin,and high-mobility group box 1 in identifying necrotising enterocolitis in newborns

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2003-2011页

作者： Li-Ming Guo Zhi-Hui Jiang Hong-Zhen Liu Lei Zhang Department of General Surgery Qingdao Women and Children’s HospitalQingdao 266000Shandong ProvinceChina Department of Pediatric Surgery Children's Hospital Affiliated to Shandong UniversityJinan 250022Shandong ProvinceChina Department of Pediatric Surgery Jinan Children's HospitalJinan 250022Shandong ProvinceChina Department of Pediatric Surgery Qilu Hospital of Shandong University(Qingdao)Qingdao 260010Shandong ProvinceChina

BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight *** amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune *** To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in *** The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the ***,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were *** diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)*** The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy *** correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of *** analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic *** combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was *** biomarkers potentially improve the early detection,risk stratification,and clinical management of critical *** findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

关键词： Serum amyloid A procalcitonin High-mobility group box 1 Necrotising enterocolitis in newborns Serum biomarkers

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Checking procalcitonin suitability for prognosis and antimicrobial therapy monitoring in burn patients

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Burns & Trauma 2018年第1期6卷 39-48页

作者： Luís Cabral Vera Afreixo Rita Meireles Miguel Vaz Catarina Chaves Marisa Caetano Luís Almeida JoséArtur Paiva Department of Plastic Surgery and Burns Unit Unidade de QueimadosCoimbra University Hospital Centre(CHUC)Av.Bissaya Barreto s/n3000-075 CoimbraPortugal Autonomous Section of Health Sciences(SACS) University of AveiroAveiroPortugal CIDMA-Center for Research and Development in Mathematics and Applications iBiMEDInstitute for BiomedicineUniversity of AveiroAveiroPortugal Clinical Pathology Department Coimbra University Hospital Centre(CHUC)CoimbraPortugal Pharmacy Department Coimbra University Hospital Centre(CHUC)CoimbraPortugal MedinUP Department of Pharmacology and TherapeuticsFaculty of MedicineUniversity of PortoPortoPortugal Department of Emergency and Intensive Care Medicine Centro Hospitalar Sao JoaoPortoPortugal Faculty of Medicine University of PortoGrupo de Infeccao e SépsisPortoPortugal.

Background: Due to greater infection susceptibility, sepsis is the main cause of death in burn patients. Quick diagnosis and patient stratification, early and appropriated antimicrobial therapy, and focus control are crucial for patients’survival. On the other hand, superfluous extension of therapy is associated with adverse events and arousal of microbial resistance. The use of biomarkers, necessarily coupled with close clinical examination, may predict outcomes, stratifying patients who need more intensive care, and monitor the efficacy of antimicrobial therapy, allowing faster de-escalation or stop, reducing the development of resistance and possibly the financial burden, without increasing mortality. The aim of this work is to check the suitability of procalcitonin (PCT) to fulfill these goals in a large sample of septic burn patients. Methods: One hundred and one patients, with 15% or more of total body surface area (TBSA) burned, admitted from January 2011 to December 2014 at Coimbra Burns Unit (CBU), in Portugal were included in the sample. All patients had a diagnosis of sepsis, according to the American Burn Association (ABA) criteria. The sample was factored by survival (68 survivors and 33 non-survivors). The maximum value of PCT in each day was used for statistical analysis. Data were summarized by location measures (mean, median, minimum, maximum, quartiles) and dispersion measures (standard error and range measures). Statistical analysis was performed with SPSS?23.0 IBM? for Windows?. Results: There were statistically significant differences between PCT levels of patients from the survivor and non-survivor groups during the first and the last weeks of hospitalization as well as during the first week after sepsis suspicion, being slightly higher during this period. During the first 7 days of antimicrobial therapy, PCT was always higher in the non-survivor, still without reaching statistical significance, but when the analysis was extended till the 15th

关键词： Burns Sepsis procalcitonin Prognosis Antimicrobial stewardship

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procalcitonin could be a reliable marker in differential diagnosis of post-implantation syndrome and infection after percutaneous endovascular aortic repair

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Chinese Medical Journal 2014年第14期127卷 2578-2582页

作者： Xue Ling Luo Songyuan Luo Jianfang Liu Zhen Gu Mengnan Kang Huiyuan Yang Fan Nie Bingrong Liu Yuan Huang Wenhui Xie Nianjin He Pengcheng Dong Haojian Ni Zhonghan Fan Ruixin Chen Jiyan Guangdong Acad Med Sci Dept Cardiol Guangdong Prov Cardiovasc Inst Guangdong Gen Hosp Guangzhou 510080 Guangdong Peoples R China Southern Med Univ Guangzhou 510000 Guangdong Peoples R China Sun Yat Sen Univ Dept Pharmacol Zhongshan Sch Med Guangzhou 510080 Guangdong Peoples R China

Background Thoracic endovascular aortic repair （TEVAR） is an emerging treatment moaality, wnicn nas been rapidly embraced by clinicians treating thoracic aortic disease. However, the clinical manifestations of systemic inflammatory response after TEVAR as post-implantation syndrome （PIS） resemble the perioperative infection. This study aimed to evaluate changes and diagnostic value of procalcitonin （PCT） and other traditional inflammatory markers for infections after TEVAR. Methods We conducted a prospective clinical study that enrolled 162 consecutive aortic dissection cases. who underwent TEVAR in our institution between July 2011 and November 2012. The PCT, C-response protein （CRP）, erythrocyte sedimentation rate （ESR） and blood routine examination were monitored before the operation and on days 1, 2, 3 and 5 after the operation. The diagnosis of infection was confirmed by the infection control committee with reference to Hospital Acquired Infection Diagnostic Criteria Assessment, released by the Ministry of Health of the People＇s Republic of China. Results Post endovascular repair of thoracic aorta, PCT changes significantly at different time points （X^2= 13.225, P=0.021）, without significant difference between the PIS group and the control group （0.24±0.04 vs.0.26±0.10, P=0.804）. PCT values were significantly higher in the first day after TEVAR than the preoperative levels （0.18±0.03 vs. 0.11±0.02, P 〈0.001）. Compared with PIS patients, the level of PCT, CRP, White blood cell （WBC） and neutrophil （NEU） in the infection patients elevated significantly （relatively X2=6.062, P=0.048; X2=6.081, P=0.048; X2=11.030, P=0.004; X2=14.632, P=0.001）. According to the ROC analysis, the PCT levels in the first day after TEVAR （AUC=0.785, P=0.012） had better predictive values of infection than WBC, NEU CRP and ESR （AUC=0.720, P=0.040; AUC=0.715, P=0.045; AUC=0.663, P=0.274; AUC=0.502, P=0.991）. The best predictive index was the changes of PCT between preoperative and postope

关键词： aortic dissection inflammatory response infection endovascular repair procalcitonin

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