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Ardelean A, Balta DF, Neamtu C, Neamtu AA, Rosu M, Pilat L, Moldovan S, Tarta C, Totolici B. Pentraxin-3 and Other Inflammatory Markers for an Infected Diabetic Foot Ulcer Diagnosis: A Prospective Study. Diagnostics (Basel) 2023; 13:2366. [PMID: 37510110 PMCID: PMC10377911 DOI: 10.3390/diagnostics13142366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
Strategies have been researched and implemented to reduce the number of people with diabetic foot ulcers (DFUs). One problem is the accurate assessment of DFU severity, which is the main factor in resource allocation and treatment choice. The primary objective of this study was to assess pentraxin-3 as a biomarker of an infected DFU (IDFU), the limb amputation level prognosis, and patient survival. The secondary objectives were to evaluate and compare other markers, including white blood cells (WBCs), C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT), for identifying IDFUs. Over a period of two years, 145 patients were followed; 131 of these were analyzed for this study. Pentraxin-3 was found to be a good predictor of death (p = 0.047). A comparison between IDFUs and DFUs revealed the following differences: PCT had the highest AUROC of 0.91, sensitivity of 93.7, and specificity of 83.3%. CRP had a cutoff value of 226 mg/L, an AUROC of 0.89, a sensitivity of 95.5%, and a specificity of 83.3%. Fibrinogen had an AUROC of 0.87 at a cutoff value of 5.29 g/L, with a good sensitivity and specificity of 85% and 87%, respectively. ESR had a cutoff value of 46 mm/h, an AUROC of 85%, a sensitivity of 83.7%, and a specificity of 83.3%. Pentraxin-3 showed promising results in predicting IDFUs and DFUs, and it served as a marker for the risk of death in IDFU patients during the 6 month follow-up. Other markers, including CRP, PCT, ESR, and fibrinogen, were more effective in differentiating between IDFUs and DFUs.
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Affiliation(s)
- Andrei Ardelean
- 1st Surgery Clinic, Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
| | | | - Carmen Neamtu
- 1st Surgery Clinic, Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
| | | | - Mihai Rosu
- 1st Surgery Clinic, Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
| | - Luminita Pilat
- Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
| | - Silviu Moldovan
- Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
| | - Cristi Tarta
- Department X, 2nd Surgical Clinic, Researching Future Chirurgie 2, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
| | - Bogdan Totolici
- 1st Surgery Clinic, Faculty of Medicine, West University "Vasile Goldis" Arad, 310025 Arad, Romania
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Jiang J, Zhong W, Huang W, Gao Y, He Y, Li X, Liu Z, Zhou H, Fu Y, Liu R, Zhang W. Development and Validation of a Predictive Nomogram with Age and Laboratory Findings for Severe COVID-19 in Hunan Province, China. Ther Clin Risk Manag 2022; 18:579-591. [PMID: 35607424 PMCID: PMC9123913 DOI: 10.2147/tcrm.s361936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose To identify more objectively predictive factors of severe outcome among patients hospitalized for coronavirus disease 2019 (COVID-19). Patients and Methods A retrospective cohort of 479 hospitalized patients diagnosed with COVID-19 in Hunan Province was selected. The prognostic effects of factors such as age and laboratory indicators were analyzed using the Kaplan–Meier method and Cox proportional hazards model. A prognostic nomogram model was established to predict the progression of patients with COVID-19. Results A total of 524 patients in Hunan province with COVID-19 from December 2019 to October 2020 were retrospectively recruited. Among them, 479 eligible patients were randomly assigned into the training cohort (n = 383) and validation cohort (n = 96), at a ratio of 8:2. Sixty-eight (17.8%) and 15 (15.6%) patients developed severe COVID-19 after admission in the training cohort and validation cohort, respectively. The differences in baseline characteristics were not statistically significant between the two cohorts with regard to age, sex, and comorbidities (P > 0.05). Multivariable analyses included age, C-reactive protein, fibrinogen, lactic dehydrogenase, neutrophil-to-lymphocyte ratio, urea, albumin-to-globulin ratio, and eosinophil count as predictive factors for patients with progression to severe COVID-19. A nomogram was constructed with sufficient discriminatory power (C index = 0.81), and proper consistency between the prediction and observation, with an area under the ROC curve of 0.81 and 0.86 in the training and validation cohort, respectively. Conclusion We proposed a simple nomogram for early detection of patients with non-severe COVID-19 but at high risk of progression to severe COVID-19, which could help optimize clinical care and personalized decision-making therapies.
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Affiliation(s)
- Junyi Jiang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
- Aier Eye Institute, Changsha, Hunan, People’s Republic of China
| | - WeiJun Zhong
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - WeiHua Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yongchao Gao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yijing He
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Zhaoqian Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Honghao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Yacheng Fu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Cofoe Medical Technology Co., Ltd, Changsha, People’s Republic of China
| | - Rong Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, People’s Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Changsha, Hunan, People’s Republic of China
- Correspondence: Wei Zhang; Rong Liu, Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China, Tel +86 731 84805380, Fax +86 731 82354476, Email ;
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