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Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis
We investigated the diagnostic and prognostic utilities of procalcitonin (PCT), B-type natriuretic peptide (BNP), and neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically or based on PCT concentrations. PCT, BNP,...
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| Published in: | BMC infectious diseases 2014-04, Vol.14 (1), p.224-224, Article 224 |
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| creator | Hur, Mina Kim, Hanah Lee, Seungho Cristofano, Flavia Magrini, Laura Marino, Rossella Gori, Chiara Serena Bongiovanni, Cristina Zancla, Benedetta Cardelli, Patrizia Di Somma, Salvatore |
| description | We investigated the diagnostic and prognostic utilities of procalcitonin (PCT), B-type natriuretic peptide (BNP), and neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically or based on PCT concentrations.
PCT, BNP, and NGAL concentrations were measured in 340 patients and were followed up in 109 patients. All studied biomarkers were analyzed according to the diagnosis, severity, and clinical outcomes of sepsis.
Clinical sepsis and PCT-based sepsis showed poor agreement (kappa = 0.2475). BNP and NGAL showed significant differences between the two groups of PCT-based sepsis (P = 0.0001 and P |
| doi_str_mv | 10.1186/1471-2334-14-224 |
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PCT, BNP, and NGAL concentrations were measured in 340 patients and were followed up in 109 patients. All studied biomarkers were analyzed according to the diagnosis, severity, and clinical outcomes of sepsis.
Clinical sepsis and PCT-based sepsis showed poor agreement (kappa = 0.2475). BNP and NGAL showed significant differences between the two groups of PCT-based sepsis (P = 0.0001 and P < 0.0001), although there was no difference between the two groups of clinical sepsis. BNP and NGAL were significantly different according to the PCT staging and sepsis-related organ failure assessment subscores (P < 0.0001, all). BNP and PCT concentrations were significantly higher in the non-survivors than in the survivors (P = 0.0002) and showed an equal ability to predict in-hospital mortality (P = 0.0001). In the survivors, the follow-up NGAL and PCT concentrations were significantly lower than the initial values (148.7 ng/mL vs. 214.5 ng/mL, P < 0.0001; 0.61 ng/mL vs. 5.56 ng/mL, P = 0.0012).
PCT-based sepsis diagnosis seems to be more reliable and discriminating than clinical sepsis diagnosis. Multimarker approach using PCT, BNP, and NGAL would be useful for the diagnosis, staging, and prognosis prediction in the critically ill patients with suspected sepsis.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/1471-2334-14-224</identifier><identifier>PMID: 24761764</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Biomarkers ; Biomarkers - blood ; Calcitonin - blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Confidence intervals ; Critical Illness ; Emergency medical care ; Family medical history ; Female ; Health aspects ; Heart failure ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infections ; Intensive care ; Lipocalins - blood ; Male ; Medical research ; Medicine ; Medicine, Experimental ; Middle Aged ; Mortality ; Natriuretic Peptide, Brain - blood ; Peptides ; Predictive Value of Tests ; Prognosis ; Protein Precursors - blood ; Sepsis ; Sepsis - blood ; Sepsis - diagnosis ; Statistical analysis ; Studies</subject><ispartof>BMC infectious diseases, 2014-04, Vol.14 (1), p.224-224, Article 224</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Hur et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Hur et al.; licensee BioMed Central Ltd. 2014 Hur et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b652t-2e9702bd1e354c2b1b27177a9a608e16ce2342bb3f9bd6e690c8a7956c8dcef23</citedby><cites>FETCH-LOGICAL-b652t-2e9702bd1e354c2b1b27177a9a608e16ce2342bb3f9bd6e690c8a7956c8dcef23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006080/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1520507718?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,44569,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24761764$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hur, Mina</creatorcontrib><creatorcontrib>Kim, Hanah</creatorcontrib><creatorcontrib>Lee, Seungho</creatorcontrib><creatorcontrib>Cristofano, Flavia</creatorcontrib><creatorcontrib>Magrini, Laura</creatorcontrib><creatorcontrib>Marino, Rossella</creatorcontrib><creatorcontrib>Gori, Chiara Serena</creatorcontrib><creatorcontrib>Bongiovanni, Cristina</creatorcontrib><creatorcontrib>Zancla, Benedetta</creatorcontrib><creatorcontrib>Cardelli, Patrizia</creatorcontrib><creatorcontrib>Di Somma, Salvatore</creatorcontrib><title>Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>We investigated the diagnostic and prognostic utilities of procalcitonin (PCT), B-type natriuretic peptide (BNP), and neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically or based on PCT concentrations.
PCT, BNP, and NGAL concentrations were measured in 340 patients and were followed up in 109 patients. All studied biomarkers were analyzed according to the diagnosis, severity, and clinical outcomes of sepsis.
Clinical sepsis and PCT-based sepsis showed poor agreement (kappa = 0.2475). BNP and NGAL showed significant differences between the two groups of PCT-based sepsis (P = 0.0001 and P < 0.0001), although there was no difference between the two groups of clinical sepsis. BNP and NGAL were significantly different according to the PCT staging and sepsis-related organ failure assessment subscores (P < 0.0001, all). BNP and PCT concentrations were significantly higher in the non-survivors than in the survivors (P = 0.0002) and showed an equal ability to predict in-hospital mortality (P = 0.0001). In the survivors, the follow-up NGAL and PCT concentrations were significantly lower than the initial values (148.7 ng/mL vs. 214.5 ng/mL, P < 0.0001; 0.61 ng/mL vs. 5.56 ng/mL, P = 0.0012).
PCT-based sepsis diagnosis seems to be more reliable and discriminating than clinical sepsis diagnosis. Multimarker approach using PCT, BNP, and NGAL would be useful for the diagnosis, staging, and prognosis prediction in the critically ill patients with suspected sepsis.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Calcitonin - blood</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence intervals</subject><subject>Critical Illness</subject><subject>Emergency medical care</subject><subject>Family medical history</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Lipocalins - blood</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptides</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Protein Precursors - blood</subject><subject>Sepsis</subject><subject>Sepsis - blood</subject><subject>Sepsis - diagnosis</subject><subject>Statistical analysis</subject><subject>Studies</subject><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNqNk9tu1DAQhiMEoqVwzxWyxA1ITbGdg5ObSqWcKlWqxOnWcpzJ7hSvHWwH6EPyTjjddumiIlAsxR5__z-jGTnLHjN6wFhTv2ClYDkvijJnZc55eSfb3YTu3tjvZA9COKeUiYa397MdXoqaibrczX6-QrWwLkTURNmejN5dH6eIBiNCIG4gq8lEXCn_BXwgakyY0ksyBbSLWaOV0RidRbtPXubxYgRiVfQ4eZitRhgj9rB_mcLCFL0bl2jIAoyKaFWAXIXgNKoIPTE4zoZoSVrapxrSyVwQNIaMiQcbA_mOcUnCFEbQsybAGDA8zO4NygR4dPXfyz69ef3x-F1-evb25PjoNO_qisecQyso73oGRVVq3rGOCyaEalVNG2C1Bl6UvOuKoe36GuqW6kaJtqp102sYeLGXHa59x6lbQYrZ6JWRo59bdCGdQrl9Y3EpF-6bLClNKWgyOF4bdOj-YrB9o91KzuOU8zjTTqZpJ5dnV2V493WCEOUKgwZjlAU3BcmqomwKwS8T_hPlZcOLiiX06R_ouZu8Tf1MFKcVFYI1v6mFMiDRDi7VqWdTeVQVbSUqVotEHdxCpa-HFWpnYcAU3xI83xIkJsKPuFBTCPLkw_v_Z88-b7N0zWrvQvAwbHrNqJzf0m3dfXJzyBvB9eMpfgFJTh3l</recordid><startdate>20140424</startdate><enddate>20140424</enddate><creator>Hur, Mina</creator><creator>Kim, Hanah</creator><creator>Lee, Seungho</creator><creator>Cristofano, Flavia</creator><creator>Magrini, Laura</creator><creator>Marino, Rossella</creator><creator>Gori, Chiara Serena</creator><creator>Bongiovanni, Cristina</creator><creator>Zancla, Benedetta</creator><creator>Cardelli, Patrizia</creator><creator>Di Somma, Salvatore</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140424</creationdate><title>Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis</title><author>Hur, Mina ; Kim, Hanah ; Lee, Seungho ; Cristofano, Flavia ; Magrini, Laura ; Marino, Rossella ; Gori, Chiara Serena ; Bongiovanni, Cristina ; Zancla, Benedetta ; Cardelli, Patrizia ; Di Somma, Salvatore</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b652t-2e9702bd1e354c2b1b27177a9a608e16ce2342bb3f9bd6e690c8a7956c8dcef23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Calcitonin - blood</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Confidence intervals</topic><topic>Critical Illness</topic><topic>Emergency medical care</topic><topic>Family medical history</topic><topic>Female</topic><topic>Health aspects</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Lipocalins - blood</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptides</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Protein Precursors - blood</topic><topic>Sepsis</topic><topic>Sepsis - blood</topic><topic>Sepsis - diagnosis</topic><topic>Statistical analysis</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hur, Mina</creatorcontrib><creatorcontrib>Kim, Hanah</creatorcontrib><creatorcontrib>Lee, Seungho</creatorcontrib><creatorcontrib>Cristofano, Flavia</creatorcontrib><creatorcontrib>Magrini, Laura</creatorcontrib><creatorcontrib>Marino, Rossella</creatorcontrib><creatorcontrib>Gori, Chiara Serena</creatorcontrib><creatorcontrib>Bongiovanni, Cristina</creatorcontrib><creatorcontrib>Zancla, Benedetta</creatorcontrib><creatorcontrib>Cardelli, Patrizia</creatorcontrib><creatorcontrib>Di Somma, Salvatore</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Science (Gale in Context)</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hur, Mina</au><au>Kim, Hanah</au><au>Lee, Seungho</au><au>Cristofano, Flavia</au><au>Magrini, Laura</au><au>Marino, Rossella</au><au>Gori, Chiara Serena</au><au>Bongiovanni, Cristina</au><au>Zancla, Benedetta</au><au>Cardelli, Patrizia</au><au>Di Somma, Salvatore</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis</atitle><jtitle>BMC infectious diseases</jtitle><addtitle>BMC Infect Dis</addtitle><date>2014-04-24</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>224</spage><epage>224</epage><pages>224-224</pages><artnum>224</artnum><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>We investigated the diagnostic and prognostic utilities of procalcitonin (PCT), B-type natriuretic peptide (BNP), and neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically or based on PCT concentrations.
PCT, BNP, and NGAL concentrations were measured in 340 patients and were followed up in 109 patients. All studied biomarkers were analyzed according to the diagnosis, severity, and clinical outcomes of sepsis.
Clinical sepsis and PCT-based sepsis showed poor agreement (kappa = 0.2475). BNP and NGAL showed significant differences between the two groups of PCT-based sepsis (P = 0.0001 and P < 0.0001), although there was no difference between the two groups of clinical sepsis. BNP and NGAL were significantly different according to the PCT staging and sepsis-related organ failure assessment subscores (P < 0.0001, all). BNP and PCT concentrations were significantly higher in the non-survivors than in the survivors (P = 0.0002) and showed an equal ability to predict in-hospital mortality (P = 0.0001). In the survivors, the follow-up NGAL and PCT concentrations were significantly lower than the initial values (148.7 ng/mL vs. 214.5 ng/mL, P < 0.0001; 0.61 ng/mL vs. 5.56 ng/mL, P = 0.0012).
PCT-based sepsis diagnosis seems to be more reliable and discriminating than clinical sepsis diagnosis. Multimarker approach using PCT, BNP, and NGAL would be useful for the diagnosis, staging, and prognosis prediction in the critically ill patients with suspected sepsis.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24761764</pmid><doi>10.1186/1471-2334-14-224</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC infectious diseases, 2014-04, Vol.14 (1), p.224-224, Article 224 |
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| source | Publicly Available Content (ProQuest); PubMed Central |
| subjects | Adolescent Adult Aged Aged, 80 and over Analysis Biomarkers Biomarkers - blood Calcitonin - blood Calcitonin Gene-Related Peptide Child Child, Preschool Confidence intervals Critical Illness Emergency medical care Family medical history Female Health aspects Heart failure Hospitals Humans Infant Infant, Newborn Infections Intensive care Lipocalins - blood Male Medical research Medicine Medicine, Experimental Middle Aged Mortality Natriuretic Peptide, Brain - blood Peptides Predictive Value of Tests Prognosis Protein Precursors - blood Sepsis Sepsis - blood Sepsis - diagnosis Statistical analysis Studies |
| title | Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis |
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