دورية أكاديمية
أعرض في EDS

The utility of procalcitonin for diagnosing bacteremia and bacterial pneumonia in hospitalized oncology patients.

التفاصيل البيبلوغرافية
العنوان: The utility of procalcitonin for diagnosing bacteremia and bacterial pneumonia in hospitalized oncology patients.
المؤلفون: Munsell MK; Harvard Medical School, Boston, MA, USA., Fadelu T; Harvard Medical School, Boston, MA, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.; Brigham and Women's Hospital, Boston, MA, USA., Stuver SO; Dana-Farber Cancer Institute, Boston, MA, USA.; School of Public Health, Boston University, Boston, MA, USA., Baker KP; Harvard Medical School, Boston, MA, USA.; Brigham and Women's Hospital, Boston, MA, USA., Glotzbecker B; Harvard Medical School, Boston, MA, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.; Brigham and Women's Hospital, Boston, MA, USA., Simmons JL; Harvard Medical School, Boston, MA, USA.; Dana-Farber Cancer Institute, Boston, MA, USA.; Brigham and Women's Hospital, Boston, MA, USA., Reynolds KL; Harvard Medical School, Boston, MA, USA.; Massachusetts General Hospital, Boston, MA, USA., Patel AK; Harvard Medical School, Boston, MA, USA. ami_patel@dfci.harvard.edu.; Dana-Farber Cancer Institute, Boston, MA, USA. ami_patel@dfci.harvard.edu.; Brigham and Women's Hospital, Boston, MA, USA. ami_patel@dfci.harvard.edu.
المصدر: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 Jul; Vol. 149 (8), pp. 5193-5204. Date of Electronic Publication: 2022 Nov 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 7902060 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1335 (Electronic) Linking ISSN: 01715216 NLM ISO Abbreviation: J Cancer Res Clin Oncol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Berlin ; New York : Springer-Verlag.
مواضيع طبية MeSH: Bacteremia*/diagnosis , Pneumonia, Bacterial*/diagnosis , Pneumonia, Bacterial*/complications , Hematologic Neoplasms*/complications, Humans ; Procalcitonin ; Calcitonin ; Biomarkers ; Retrospective Studies ; ROC Curve ; C-Reactive Protein/analysis
مستخلص: Purpose: Procalcitonin (PCT) is an inflammatory marker elevated in bacteremia and bacterial pneumonia. We aimed to assess the real-world diagnostic accuracy of PCT in hospitalized patients with malignancy.
Methods: A retrospective cohort of 715 patients with cancer who had PCT measured during 750 admissions was analyzed. Diagnosis of bacteremia was determined using blood culture data. Diagnosis of bacterial pneumonia was based on radiographic infiltrate and/or sputum culture. PCT's performance was assessed using receiver operating characteristic (ROC) curves, sensitivity, and specificity.
Results: Patients had bacteremia, bacterial pneumonia, or both during 210 admissions (28%). PCT elevation above 0.5 ng/mL was significantly associated with diagnosed infection in the overall population (p < 0.0001) and in subgroups with solid tumor malignancies (p < 0.0001) and hematologic malignancies (p = 0.008). PCT was associated with infectious status in patients with any metastases, but not those with primary lung cancer, lung metastases, neuroendocrine tumors, febrile neutropenia, or history of bone marrow transplant (BMT). The area under the ROC curve for PCT in the overall population was 0.655. An ideal cutoff of 0.21 ng/mL led to a sensitivity of 60% and specificity of 59%. At cutoffs of 0.5 ng/mL and 0.05 ng/mL, PCT's sensitivity was 39% and 94%, while specificity was 79% and 17%, respectively.
Conclusion: In this large cohort of hospitalized oncology patients, PCT elevation was associated with diagnosed bacteremia and/or bacterial pneumonia. However, specificity was limited, and PCT elevation was not associated with diagnosed infection in some subpopulations. While PCT may have some diagnostic utility for hospitalized oncology patients, values must be interpreted cautiously and considering clinical context.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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فهرسة مساهمة: Keywords: Bacteremia; Diagnostic marker; Inpatient; Oncology; Pneumonia; Procalcitonin
المشرفين على المادة: 0 (Procalcitonin)
9007-12-9 (Calcitonin)
0 (Biomarkers)
9007-41-4 (C-Reactive Protein)
تواريخ الأحداث: Date Created: 20221113 Date Completed: 20230719 Latest Revision: 20230719
رمز التحديث: 20240829
DOI: 10.1007/s00432-022-04419-x
PMID: 36371720
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-1335
DOI:10.1007/s00432-022-04419-x