Differences in the effectiveness of serum biomarkers for the diagnosis of bacterial infections in adult and elderly patients admitted to the emergency department

Background/aim: This study aimed to evaluate the superiority of procalcitonin (PCT), C-reactive protein (CRP) levels, white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESR) in discriminating among infection, systemic inflammatory response syndrome (SIRS), and sepsis, and their differences according to age groups. Materials and methods: The patients were divided into an adult group and a geriatric group (over 65 years) and classified according to the presence of infection, SIRS, and sepsis. The patients' laboratory values (PCT, CRP, WBC, ESR), demographic characteristics, and vital signs were taken into consideration. Results: When the laboratory parameters were evaluated, there were no significant differences in the PCT, WBC, and ESR values between the age groups (P > 0.05). CRP was significantly higher in the adult patient group compared to the geriatric group (P < 0.001). When the two groups were compared in terms of infection, there were no significant differences in the PCT levels and the WBC count (P > 0.05) in SIRS and sepsis. In addition, the CRP levels and the ESR were significantly higher in the adult sepsis patients when compared with the geriatric patients (P < 0.001). Conclusion: PCT levels do not distinguish among infection, SIRS, and sepsis in adult and geriatric age groups.

Differences in the effectiveness of serum biomarkers for the diagnosis of bacterial infections in adult and elderly patients admitted to the emergency department

Background/aim: This study aimed to evaluate the superiority of procalcitonin (PCT), C-reactive protein (CRP) levels, white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESR) in discriminating among infection, systemic inflammatory response syndrome (SIRS), and sepsis, and their differences according to age groups. Materials and methods: The patients were divided into an adult group and a geriatric group (over 65 years) and classified according to the presence of infection, SIRS, and sepsis. The patients' laboratory values (PCT, CRP, WBC, ESR), demographic characteristics, and vital signs were taken into consideration. Results: When the laboratory parameters were evaluated, there were no significant differences in the PCT, WBC, and ESR values between the age groups (P > 0.05). CRP was significantly higher in the adult patient group compared to the geriatric group (P < 0.001). When the two groups were compared in terms of infection, there were no significant differences in the PCT levels and the WBC count (P > 0.05) in SIRS and sepsis. In addition, the CRP levels and the ESR were significantly higher in the adult sepsis patients when compared with the geriatric patients (P < 0.001). Conclusion: PCT levels do not distinguish among infection, SIRS, and sepsis in adult and geriatric age groups.

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  • Hosoglu S, Parlak Z, Geyik MF, Palanci Y. Critical evaluation of antimicrobial use--a Turkish university hospital example. J Infect Dev Ctries 2013; 7: 873–879. 4. Angus DC, Randy SW. Epidemiology of sepsis; an update. Crit Care Med 2001; 9: 109–116.
  • Hicks CW, Engineer RS, Benoit JL, Dasarathy S, Christenson RH, Peacock WF. Procalcitonin as a biomarker for early sepsis in the emergency department. Eur J Emerg Med 2014; 21: 112– 117.
  • Limper M, Kruif MD, Duits AJ, Brandjes DP, van Gorp EC. The diagnostic role of procalcitonin and other biomarkers in discriminating infections from non-infectious fever. J Infect 2010; 60: 409–416. 9. Maruna P, Nedelníková K, Gürlich R. Physiology and genetics of procalcitonin. Physiol Res 2000; 49: 57–61.
  • Uusitalo-Seppala R, Koskinen P, Leino A, Peuravuori H, Vahlberg T, Rintala EM. Early detection of severe sepsis in the emergency room: diagnostic value of plasma C-reactive protein, procalcitonin, and interleukin-6. Scand J Infect Dis 2011; 43: 883–890.
  • Magrini L, Travaglino F, Marino R, Ferri E, De Berardinis B, Cardelli P, Salerno G, Di Somma S. Procalcitonin variations after Emergency Department admission are highly predictive of hospital mortality in patients with acute infectious diseases. Eur Rev Med Pharmacol Sci 2013; 17: 133–142.
  • Shen CJ, Wu MS, Lin KH, Lin WL, Chen HC, Wu JY, Lee MC, Lee CC. The use of procalcitonin in the diagnosis of bone and joint infection: a systemic review and meta-analysis. Eur J Clin Microbiol Infect Dis 2013; 32: 807–814.
  • Jaimes FA, De La Rosa GD, Valencia ML, Arango CM, Gomez CI, Garcia A, Ospina S, Osorno SC, Henao AI. A latent class approach for sepsis diagnosis supports use of procalcitonin in the emergency room for diagnosis of severe sepsis. BMC Anesthesiol 2013; 13: 23.
  • Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 1644–1655.
  • Cavaillon JM, Adib-Conquy M, Fitting C, Adrie C, Payen D. Cytokine cascade in sepsis. Scand J Infect Dis 2003; 35: 535– 544.
  • Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med 2003; 348: 138–150.
  • Russell JA. Management of sepsis. N Engl J Med 2006; 355: 1699–1713.
  • Gavazzi G, Krause KH. Ageing and infection. Lancet Infect Dis 2002; 2: 659–666.
  • Lai CC, Chen SY, Wang CY, Wang JY, Su CP, Liao CH, Tan CK, Huang YT, Lin HI, Hsueh PR. Diagnostic value of procalcitonin for bacterial infection in elderly patients in the emergency department. J Am Geriatr Soc 2010; 58: 518–522.
  • Heppner HJ, Bertsch T, Alber B, Esslinger AS, Dragonas C, Bauer JM, Sieber CC, Steichen O, Bouvard E, Grateau G et al. Diagnostic value of procalcitonin in acutely hospitalized elderly patients. Eur J Clin Microbiol Infect Dis 2009; 28: 1471– 1476.
  • Mondal SK, Nag DR, Bandyopadhyay R, Chakraborty D, Sinha SK. Neonatal sepsis: role of a battery of immunohematological tests in early diagnosis. Int J Appl Basic Med Res 2012; 2: 43– 47.
  • Kaur K, Mahajan R, Tanwar A. A novel marker procalcitonin may help stem the antibiotic overuse in emergency setting. Int J Appl Basic Med Res 2013; 3: 77–83.
  • Hoeboer SH, Groeneveld AB. Changes in circulating procalcitonin versus C-reactive protein in predicting evolution of infectious disease in febrile, critically ill patients. PLoS One 2013; 8: e65564.
  • Cornelissen CG, Frechen DA, Schreiner K, Marx N, Krüger S. Inflammatory parameters and prediction of prognosis in infective endocarditis. BMC Infect Dis 2013; 13: 272.
  • Ha YE, Kang CI, Wi YM, Chung DR, Kang ES, Lee NY, Song JH, Peck KR. Diagnostic usefulness of procalcitonin as a marker of bacteremia in patients with acute pyelonephritis. Scand J Clin Lab Invest 2013; 73: 444–448.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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