Department of Anesthesiology and Reanimation, Intensive Care Unit, SBU Tepecik Training and Research Hospital, İzmir, Turkey.
Department of Anesthesiology and Reanimation, Intensive Care Unit, Bozyaka Training and Research Hospital, İzmir, Turkey.
Turk J Med Sci. 2021 Oct;51(5):2649-2656. doi: 10.3906/sag-2007-268. Epub 2021 Oct 21.
Biomarkers are useful for diagnosing infection and sepsis in adults, but data are limited in elderly patients. Furthermore, clinical symptoms of infection in elderly patients are usually atypical or unclear. We aimed to assess the usefulness of PCT, CRP, and WBC in distinguishing elderly patients infected with sepsis from infected without sepsis and those with no-infection. We also aimed to find a cut-off value for diagnosing sepsis and infection without sepsis in elderly critically ill patients.
In this single-center and prospective observational study, patients older than 65 years were enrolled. Serum levels of PCT, CRP, and WBC were measured within 24 h. Patients were allocated into sepsis (S), infected without sepsis (IWS), and noinfection (NI) groups. Data were analyzed with Mann-Whitney U test and Kruskal-Wallis test.
We analyzed 188 patients with a mean age of 77.05 ± 7.4 in the study; 95 (50.5%) of them were women. Sixty-four (34%) of whom were classified as IWS, 29 (15%) as S, and 95 (50.5%) as NI group. There were significant differences in the PCT, CRP levels between the IWS and NI, S and NI (p < 0.001, p < 0.001, p < 0.001, p < 0.01, respectively). The PCT levels were significantly different when the NI group was compared to IWS (p < 0.001) and S (p < 0.001) groups. The CRP levels were also different when the NI group was compared to both IWS (p < 0.001) and S (p < 0.001). The PCT cut-off values were 0.485 μ/L and 1.245 μg/L for the discrimination of patients with IWS and S, respectively. The cut-off values of CRP level were 59.45 mg/L and 57.50 mg/L for infected without sepsis and sepsis, respectively.
PCT was found to be a more valuable marker than CRP and WBC for the discrimination of elderly patients with infected without sepsis and sepsis.
生物标志物对于诊断成人感染和败血症很有用，但在老年患者中的数据有限。此外，老年患者感染的临床症状通常不典型或不明确。我们旨在评估 PCT、CRP 和 WBC 在区分感染性败血症、感染但无败血症和无感染的老年患者中的作用。我们还旨在为老年危重症患者确定诊断败血症和感染但无败血症的截断值。
这是一项单中心前瞻性观察研究，纳入年龄大于 65 岁的患者。在 24 小时内测量 PCT、CRP 和 WBC 的血清水平。患者被分配到败血症（S）、感染但无败血症（IWS）和无感染（NI）组。采用 Mann-Whitney U 检验和 Kruskal-Wallis 检验进行数据分析。
本研究共纳入 188 例平均年龄 77.05 ± 7.4 岁的患者，其中 95 例（50.5%）为女性。64 例（34%）被分类为 IWS，29 例（15%）为 S，95 例（50.5%）为 NI 组。IWS 与 NI、S 与 NI 之间的 PCT、CRP 水平差异有统计学意义（p<0.001，p<0.001，p<0.001，p<0.01）。NI 组与 IWS（p<0.001）和 S（p<0.001）组比较，PCT 水平差异有统计学意义。NI 组与 IWS（p<0.001）和 S（p<0.001）组比较，CRP 水平差异也有统计学意义。PCT 区分 IWS 和 S 的截断值分别为 0.485 μ/L 和 1.245 μg/L。CRP 区分感染但无败血症和败血症的截断值分别为 59.45 mg/L 和 57.50 mg/L。
与 CRP 和 WBC 相比，PCT 对区分感染但无败血症和败血症的老年患者更有价值。
