Serum procalcitonin level for the prediction of severity in women with acute pyelonephritis in the ED: value of procalcitonin in acute pyelonephritis☆☆☆
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Yeouido St Mary's Hospital, Seoul, Korea
Correspondence
Corresponding author. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Yeouido St Mary's Hospital, 10, Yuksam-Ro, Yeongdeungpo-Gu, Seoul 150-713, Korea.
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Yeouido St Mary's Hospital, Seoul, Korea
Correspondence
Corresponding author. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Yeouido St Mary's Hospital, 10, Yuksam-Ro, Yeongdeungpo-Gu, Seoul 150-713, Korea.
To view the full text, please login as a subscribed user or purchase a subscription.
Click here to view the full text on ScienceDirect.
Figures
Fig. 1
The ROC curves of PCT, hs-CRP, ESR, and WBC count for the prediction of sepsis (A), severe sepsis (B), and septic shock (C) in women with APN.
Fig. 2
The ROC curve for the prognostic value of PCT and disease classification systems to predict mortality of APN.
Abstract
Purpose
Predicting medical outcomes for acute pyelonephritis (APN) in women is difficult. Delay in diagnosis and treatment often results in rapid progression to circulatory collapse, multiple-organ failure, and death. The aim of this study was to investigate the value of procalcitonin (PCT) level in women with APN at ED.
Methods
We conducted a prospective study of women with APN presenting to the ED. The authors measured inflammatory biomarkers, and the severity of pyelonephritis was assessed by 4 severity of disease classification system and stage of sepsis. We performed an analysis to assess the value of PCT for the prediction of 28-day mortality and disease severity.
Results
A total of 240 female patients with APN are included. Patients were divided into 4 groups on the basis of systemic inflammatory response syndrome criteria, organ dysfunction, and persistent hypotension. The median PCT level was higher in the septic shock group compared with other groups. Of the other inflammatory markers, only white blood cell count was significantly different among the groups, whereas high-sensitivity C-reactive protein level and erythrocyte sedimentation rate revealed no differences. The area under the curve for PCT in predicting 28-day mortality was 0.68. For predicting mortality, a cutoff value of 0.42 ng/mL had a sensitivity of 80% and a specificity of 50%. However, the disease classification systems were demonstrated to be superior to PCT in predicting 28-day mortality.
Conclusions
Relative to other classic markers of inflammation, by distinguishing the severity of sepsis related to APN, PCT levels can provide additional aid to clinicians in disease severity classification and their decision of treatment at ED.
To access this article, please choose from the options below
Article Info
