학술논문
Accuracy of Pancreatic Stone Protein for diagnosis of sepsis in children admitted to pediatric intensive care or high-dependency care: a pilot study.
Document Type
Article
Author
Bottari, Gabriella; Caruso, Mariangela; Paionni, Emanuel; De Luca, Maia; Romani, Lorenza; Pisani, Mara; Grandin, Annalisa; Gargiullo, Livia; Zampini, Giorgio; Gagliardi, Chiara; Fegatelli, Danilo Alunni; Vestri, Annarita; Lancella, Laura; Porzio, Ottavia; Muda, Andrea Onetti; Villani, Alberto; Atti, Marta Ciofi Degli; Raponi, Massimiliano; Cecchetti, Corrado
Source
Subject
*PANCREAS
*PROTEINS
*INTENSIVE care units
*PILOT projects
*C-reactive protein
*PEDIATRICS
*CALCITONIN
*SEPSIS
*RESEARCH funding
*SURVIVAL analysis (Biometry)
*SENSITIVITY & specificity (Statistics)
*CHILDREN
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Language
ISSN
1720-8424
Abstract
Background: Pancreatic Stone Protein (PSP) is one of the most promising diagnostic and prognostic markers. The aim of the study was to assess the accuracy of PSP, compared to C-Reactive Protein (CRP), and Procalcitonin (PCT) for sepsis diagnosis in pediatric patients. Furthermore, we explored the correlation of PSP levels with sepsis severity and organ failure measured with PELOD-2 score. Methods: Forty pediatric patients were enrolled following admission to pediatric intensive care, high dependency care or pediatric ward. PSP blood levels were measured in Emergency Department (nanofluidic point-of-care immunoassay; abioSCOPE, Abionic SA, Switzerland) on day 1, 2, 3, 5 and 7 from the onset of the clinical signs and symptoms of sepsis or SIRS. Inclusion criteria were: 1) patient age (1 month to 18 years old), 2) signs and symptoms of SIRS, irrespective of association with organ dysfunction. Exclusion criteria were: 1) hemato-oncological diseases and/or immunodeficiencies, 2) pancreatic diseases. Results: Septic patients showed higher PSP levels than those with non-infectious systemic inflammation. The optimal cut-off in diagnosis of sepsis for PSP at day 1 was 167 ng/ml resulted in a sensitivity of 59% (95% IC 36%—79%) and a specificity of 83% (95% IC 58%-96%) with an AUC of 0.636 for PSP in comparison to AUC of 0.722 for PCT and 0.503 for C-RP. ROC analysis for outcome (survival versus no survival) has showed AUC 0.814 for PSP; AUC 0.814 for PCT; AUC of 0.657 for C-RP. Conclusions: PSP could distinguish sepsis from non-infectious systemic inflammation; however, our results need to be confirmed in larger pediatric population. [ABSTRACT FROM AUTHOR]