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Diagnostic reliability of the procalcitonin serum marker in septic frail patient

Authors
  • Romano, Antonino Davide1
  • Lo Buglio, Aurelio1
  • Bellanti, Francesco1
  • Villani, Rosanna1
  • Serviddio, Gaetano1
  • Vendemiale, Gianluigi1
  • 1 University of Foggia, Department of Medical and Surgical Sciences, Ce.R.M.I.-Centre for Aging Research, Viale Pinto 1, Foggia, 71121, Italy , Foggia (Italy)
Type
Published Article
Journal
Aging Clinical and Experimental Research
Publisher
Springer-Verlag
Publication Date
Aug 21, 2018
Volume
31
Issue
5
Pages
727–732
Identifiers
DOI: 10.1007/s40520-018-1020-z
Source
Springer Nature
Keywords
License
Yellow

Abstract

AimAging is associated with increased inflammation, particularly in frailty. Indeed, such patient presents increased serum inflammatory markers, such as C-reactive protein and interleukin-6. Interleukin-6 is an important stimulating factor for the production of procalcitonin. The aim of this study is to evaluate the diagnostic reliability of serum PCT in the diagnosis of sepsis in frail elderly patients.MethodsUsing Fried’s criteria for frailty, 140 older patients hospitalized for any cause were consecutively enrolled and divided in two groups: no-frail (60 patients) and frail (80 patients). Patients were further categorized on the basis of the presence/absence of sepsis. Interleukin-6, procalcitonin and inflammatory indices were sampled at hospital admission.ResultsSeptic patients from frail and no-frail groups showed higher values of interleukin-6 and procalcitonin. However, focusing on groups without sepsis, a statistically significant difference of interleukin-6 and procalcitonin values among frail and no-frail groups was seen at the post-hoc analysis. In frail group, procalcitonin cut-off of 0.5 ng/ml had a sensibility and specificity, respectively, of 100 and 22%. Through receiver operating characteristic curve (ROC) analysis, we found that procalcitonin serum value of 1.4 ng/ml had better sensibility and specificity (respectively, 93.8 and 84.4%, AUC 0.965).ConclusionsIn our study, we confirm the diagnostic reliability of procalcitonin in frail elderly patients for the diagnosis of sepsis. We found that 1.4 ng/ml was the best cut-off in this population.

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