1. Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery
- Author
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Dong Zhao, Go Haraguchi, Jianxin Zhou, Hirokuni Arai, and Chieko Mitaka
- Subjects
medicine.medical_specialty ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Procalcitonin ,C-reactive protein ,Sepsis ,White blood cell ,Internal medicine ,parasitic diseases ,medicine ,Intensive care medicine ,biology ,business.industry ,Septic shock ,Research ,Cardiac surgery ,medicine.disease ,bacterial infections and mycoses ,humanities ,Systemic inflammatory response syndrome ,medicine.anatomical_structure ,Shock (circulatory) ,biology.protein ,medicine.symptom ,business ,Infection ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background This study was performed to assess the value of procalcitonin (PCT) for the differential diagnosis between infectious and non-infectious systemic inflammatory response syndrome (SIRS) after cardiac surgery. Methods Patients diagnosed with SIRS after cardiac surgery between April 1, 2011 and March 31, 2013 were retrospectively studied. A total of 142 patients with SIRS, infectious (n = 47) or non-infectious (n = 95), were included. The patients with infectious SIRS included 11 with sepsis, 12 with severe sepsis without shock, and 24 with septic shock. Results PCT, C-reactive protein (CRP), and the white blood cell (WBC) count were significantly higher in the infectious SIRS group than in the non-infectious SIRS group. PCT had the highest sensitivity and specificity for differential diagnosis, with a cut-off value for infectious SIRS of 0.47 ng/mL. PCT was more reliable than CRP in diagnosing severe sepsis without shock, but it was not useful for diagnosing septic shock. The PCT cut-off value for diagnosing severe sepsis without shock was 2.28 ng/mL. Conclusions PCT was a useful marker for the diagnosis of infectious SIRS after cardiac surgery. The optimal PCT cut-off value for diagnosing infectious SIRS was 0.47 ng/mL.
- Published
- 2014