Scandinavian journal of trauma, resuscitation and emergency medicine · 2025
Human neutrophil lipocalin, procalcitonin, c-reactive protein, and leucocyte count for prediction of bacterial sepsis in emergency department patients.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Benhamou Jonathan, Nieves-Ortega Ricardo, Nickel Christian H, Lampart Alina, Kuster Tobias, Balestra Gianmarco M, Rosin Christiane, Becker Christoph, Lippay Kriemhild, Bingisser Roland
Аннотация
BACKGROUND: Delayed identification of bacterial sepsis undermines the initiation of antibiotic and other time-sensitive treatments in the emergency department (ED). We aimed to investigate the performance of human-neutrophil lipocalin (HNL), procalcitonin (PCT), C-reactive protein (CRP), and leucocyte count in conjunction with clinical scores for the early prediction of bacterial sepsis.
METHODS: Patients presenting to the emergency department (ED) with a suspected infection and a national early warning score (NEWS) ≥ 2 at triage were screened for eligibility. The study biomarkers were measured at ED presentation. The primary outcome was bacterial sepsis, defined as an acute bacterial infection and an increase of ≥ 2 points in the sequential organ failure assessment (SOFA) score (Sepsis-3 criteria). The diagnostic accuracy of the biomarkers for bacterial sepsis was calculated using receiver operating curve (ROC) analysis and its area under the curve (AUC) with 95% confidence intervals (CI).
RESULTS: In total, we included 421 patients, of whom 155 (36.8%) had bacterial sepsis. For the prediction of bacterial sepsis, PCT outperformed the other biomarkers with an AUC (95% CI) of 0.77 (0.72-0.82), compared to HNL 0.72 (0.67-0.77), CRP 0.71 (0.66-0.76), and leucocyte count 0.64 (0.59-0.70). A combination of serum HNL with NEWS and SOFA at presentation had the best predictive value for bacterial sepsis at 48 h after ED presentation (AUC 0.83).
CONCLUSION: Our findings do not support the routine use of serum HNL as a tool in the prediction of bacterial sepsis in patients presenting to the ED. A combination of biomarkers (serum HNL or CRP plus leucocytes) with NEWS and SOFA at presentation outperformed inflammatory biomarkers used individually in the prediction of bacterial sepsis.
METHODS: Patients presenting to the emergency department (ED) with a suspected infection and a national early warning score (NEWS) ≥ 2 at triage were screened for eligibility. The study biomarkers were measured at ED presentation. The primary outcome was bacterial sepsis, defined as an acute bacterial infection and an increase of ≥ 2 points in the sequential organ failure assessment (SOFA) score (Sepsis-3 criteria). The diagnostic accuracy of the biomarkers for bacterial sepsis was calculated using receiver operating curve (ROC) analysis and its area under the curve (AUC) with 95% confidence intervals (CI).
RESULTS: In total, we included 421 patients, of whom 155 (36.8%) had bacterial sepsis. For the prediction of bacterial sepsis, PCT outperformed the other biomarkers with an AUC (95% CI) of 0.77 (0.72-0.82), compared to HNL 0.72 (0.67-0.77), CRP 0.71 (0.66-0.76), and leucocyte count 0.64 (0.59-0.70). A combination of serum HNL with NEWS and SOFA at presentation had the best predictive value for bacterial sepsis at 48 h after ED presentation (AUC 0.83).
CONCLUSION: Our findings do not support the routine use of serum HNL as a tool in the prediction of bacterial sepsis in patients presenting to the ED. A combination of biomarkers (serum HNL or CRP plus leucocytes) with NEWS and SOFA at presentation outperformed inflammatory biomarkers used individually in the prediction of bacterial sepsis.