Procalcitonin: The Laboratory Costs of Misused Tests.

BACKGROUND

The study aimed to assess the compliance of procalcitonin (PCT) testing protocols for sepsis diagnosis and antibiotic therapy guidance and evaluate the economic impact of unnecessary or inappropriate testing.

METHODS

The time intervals between tests were evaluated for all PCT requested in a tertiary hospital between January 2022 and December 2023. A cost of 20 €/test was calculated for each PCT.

RESULTS

A total number of 5,420 PCT tests were requested. A budget of 108,400 € was spent. Almost 22% of the tests were conducted within 12 hours of the first measurement, and 6% were performed more than 10 days apart, resulting in 33,580 € (30%) spent. A total of 845 patients did not have a follow-up test, and 16,900 € were spent in these cases. The median number of PCT was 3.33 tests/patient. For 23 cases, more than 10 PCT tests/patient were performed; a total of 338 tests, with the cost of 6,760 €.

CONCLUSIONS

In total, out of the 108,400 € spent on PCT tests, at least 33,580 € (30%) could have been saved by adherence to the most basic protocols regarding PCT testing: longer than 24-hours interval between measurements and follow-up of initially elevated results.