Usefulness of procalcitonin and C-reactive protein for predicting bacteremia in urinary tract infections in the emergency department.
Actas Urol Esp 2015;
39:502-10. [PMID:
25944771 DOI:
10.1016/j.acuro.2015.03.003]
[Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 12/29/2022]
Abstract
INTRODUCTION
The aim of this study was to analyze and compare the capacity of procalcitonin (PCT), C-reactive protein (CRP), lactate and leukocytes to predict the presence of bacteremia in patients with urinary tract infections (UTIs).
METHODS
Observational, retro-prospective analytical study of adult patients (≥15 years) diagnosed with UTI in an emergency department from August 2012 to January 2013.
RESULTS
The study included 328 patients diagnosed with UTI, with a mean age of 52±22 years, 74% of whom were women. Of these, 43 (13.1%) had bacteremia. For predicting bacteremia, PCT achieved the largest area under the receiver operating characteristic curve (ROC-AUC) at .993 (95% CI .987-1; P<.001). A cutoff≥1.16ng/mL achieves a sensitivity of 100%, a specificity of 97%, a positive predictive value of 84% and a negative predictive value of 100%. Lactate achieved an ROC-AUC of .844, and CRP achieved only .534. The mean values when comparing PCT levels in patients with UTIs with and without bacteremia were 8.08±16.37 and .34±.37ng/mL, respectively (P<.001).
CONCLUSIONS
For patients with UTIs in the emergency department, PCT achieves considerable diagnostic performance for suspecting bacteremia, a performance greater than that of lactate, CRP and leukocytes.
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