Open AccessThe Effect of Repeated Versus Initial Procalcitonin Measurements on Diagnosis of Infection in the Intensive Care Setting: A Prospective Observational Study
Author(s) -
Phillip D. Levin,
Matan J. Cohen,
Eden Ohev-Zion,
Samer Tannus,
Sheldon Stohl,
Alexander Avidan,
Ronit Cohen-Poraduso,
Allon E. Moses,
Charles L. Sprung,
Shmuel Benenson
Publication year - 2019
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0000000000003313
Subject(s) - medicine , procalcitonin , confidence interval , intensive care unit , observational study , cutoff , prospective cohort study , intensive care , antibiotics , sepsis , intensive care medicine , microbiology and biotechnology , biology , physics , quantum mechanics
Procalcitonin (PCT) measurement has been proposed to direct antibiotic use. We examined whether repeated PCT measurements (0, 6, and/or 12 hours) versus the initial measurement only (time 0) increased the sensitivity and specificity of PCT for diagnosing infection in intensive care unit patients. Infection was identified in 67/176 (38%) patients. The sensitivity of repeated versus the initial PCT measurement (with a cutoff value 0.5 ng/mL) was 52/67 (77%; 95% confidence interval [CI], 66%-87%) vs 46/67 (69%; 95% CI, 56%-79%; P = .04) and specificity 60/109 (55%; 95% CI, 45%-65%) vs 59/109 (54%; 95% CI, 44%-64%; P = 1.0). Repeat PCT evaluations over 12 hours did not provide a clinically significant improvement in diagnostic accuracy when compared to the initial single test.