Serum lactate and procalcitonin measurements in emergency room for the diagnosis and risk-stratification of patients with suspected infection

Biomarkers. 2012 Nov;17(7):590-6. doi: 10.3109/1354750X.2012.704645. Epub 2012 Jul 21.

Abstract

Objective: To study the contribution of lactate and procalcitonin (PCT) serum measurements for the diagnosis and the risk-stratification of patients with suspected infection presenting to the ED.

Methods: Single-center one year observational study on 462 consecutive patients. Multivariate analysis to assess variables associated with sepsis, severe sepsis, septic shock and severe outcome.

Results: Multivariate analysis (Odds ratio [95% CI]), showed that PCT was the best independent variable to identify sepsis (3.98 [2.60-6.10]), while lactate was the best to diagnose severe sepsis (10.88 [6.51-18.19]). Patients with both lactate above 2 mmol·L(-1) and PCT above 0.8 ng·mL(-1) had an enhanced risk of severe outcome.

Conclusions: the dosages of lactate and PCT are complementary for the diagnosis and risk-stratification of patients evaluated in the ED for suspected infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biomarkers / blood
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Cohort Studies
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Lactic Acid / blood*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Protein Precursors / blood*
  • ROC Curve
  • Risk Assessment
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / diagnosis*
  • Systemic Inflammatory Response Syndrome / mortality
  • Young Adult

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Lactic Acid
  • Calcitonin
  • Calcitonin Gene-Related Peptide