Abstract | BACKGROUND: Early diagnostic and prognostic stratification of patients with suspected infection is a difficult clinical challenge. We studied plasma pentraxin 3 (PTX3) upon admission to the emergency department in patients with suspected infection. METHODS: RESULTS: The median PTX3 levels in groups 1-5 were 2.6 ng/ml, 4.4 ng/ml, 5.0 ng/ml, 6.1 ng/ml and 16.7 ng/ml, respectively (p<0.001). The median PTX3 concentration was higher in severe sepsis patients compared to others (16.7 vs. 4.9 ng/ml, p<0.001) and in non-survivors (day 28 case fatality) compared to survivors (14.1 vs. 5.1 ng/ml, p<0.001). A high PTX3 level predicted the need for ICU stay (p<0.001) and hypotension (p<0.001). AUC(ROC) in the prediction of severe sepsis was 0.73 (95% CI 0.66-0.81, p<0.001) and 0.69 in case fatality (95% CI 0.58-0.79, p<0.001). PTX3 at a cut-off level for 14.1 ng/ml (optimal cut-off value for severe sepsis) showed 63% sensitivity and 80% specificity. At a cut-off level 7.7 ng/ml (optimal cut-off value for case fatality) showed 70% sensitivity and 63% specificity in predicting case fatality on day 28.In multivariate models, high PTX3 remained an independent predictor of severe sepsis and case fatality after adjusting for potential confounders. CONCLUSIONS: A high PTX3 level on hospital admission predicts severe sepsis and case fatality in patients with suspected infection.
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Authors | Raija Uusitalo-Seppälä, Reetta Huttunen, Janne Aittoniemi, Pertti Koskinen, Aila Leino, Tero Vahlberg, Esa M Rintala |
Journal | PloS one
(PLoS One)
Vol. 8
Issue 1
Pg. e53661
( 2013)
ISSN: 1932-6203 [Electronic] United States |
PMID | 23341967
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Protein Precursors
- Serum Amyloid P-Component
- PTX3 protein
- Calcitonin
- C-Reactive Protein
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- C-Reactive Protein
(metabolism)
- Calcitonin
(blood)
- Cohort Studies
- Emergency Service, Hospital
(statistics & numerical data)
- Female
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Patient Admission
- Prognosis
- Prospective Studies
- Protein Precursors
(blood)
- ROC Curve
- Regression Analysis
- Sepsis
(blood, diagnosis, mortality)
- Serum Amyloid P-Component
(metabolism)
- Young Adult
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