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Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination

Background. Elevated cytokines levels correlate with sepsis severity and mortality but their role in the diagnosis is controversial, whereas Procalcitonin (PCT) has been largely used. Recently, the mid-regional proadrenomedullin (MR-proADM) has been combined with PCT for diagnosis optimization. In t...

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Autores principales: Angeletti, Silvia, Dicuonzo, Giordano, Fioravanti, Marta, De Cesaris, Marina, Fogolari, Marta, Lo Presti, Alessandra, Ciccozzi, Massimo, De Florio, Lucia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655267/
https://www.ncbi.nlm.nih.gov/pubmed/26635427
http://dx.doi.org/10.1155/2015/951532
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author Angeletti, Silvia
Dicuonzo, Giordano
Fioravanti, Marta
De Cesaris, Marina
Fogolari, Marta
Lo Presti, Alessandra
Ciccozzi, Massimo
De Florio, Lucia
author_facet Angeletti, Silvia
Dicuonzo, Giordano
Fioravanti, Marta
De Cesaris, Marina
Fogolari, Marta
Lo Presti, Alessandra
Ciccozzi, Massimo
De Florio, Lucia
author_sort Angeletti, Silvia
collection PubMed
description Background. Elevated cytokines levels correlate with sepsis severity and mortality but their role in the diagnosis is controversial, whereas Procalcitonin (PCT) has been largely used. Recently, the mid-regional proadrenomedullin (MR-proADM) has been combined with PCT for diagnosis optimization. In this study the combined measurement of PCT, MR-proADM, and cytokines in patients with sepsis was evaluated. Methods. One hundred and four septic patients and 101 controls were enrolled. Receiver operating characteristic (ROC) analysis and multiple logistic regression were used to evaluate applicant markers for sepsis diagnosis. Markers with best Odds Ratio (OR) were combined, and the posttest probability and a composite score were computed. Results. Based upon ROC curves analysis, PCT, MR-proADM, IL-6, IL-10, TNF-α, and MCP-1 were considered applicant for sepsis diagnosis. Among these PCT, MR-proADM , IL-6, and TNF-α showed the best OR. A better posttest probability was found with the combination of PCT with MR-proADM and PCT with IL-6 or TNF-α compared to the single marker. A composite score of PCT, MR-proADM, and TNF-α showed the best ROC curve in the early diagnosis of sepsis. Conclusion. The combination of PCT with other markers should expedite diagnosis and treatment of sepsis optimizing clinical management.
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spelling pubmed-46552672015-12-03 Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination Angeletti, Silvia Dicuonzo, Giordano Fioravanti, Marta De Cesaris, Marina Fogolari, Marta Lo Presti, Alessandra Ciccozzi, Massimo De Florio, Lucia Dis Markers Research Article Background. Elevated cytokines levels correlate with sepsis severity and mortality but their role in the diagnosis is controversial, whereas Procalcitonin (PCT) has been largely used. Recently, the mid-regional proadrenomedullin (MR-proADM) has been combined with PCT for diagnosis optimization. In this study the combined measurement of PCT, MR-proADM, and cytokines in patients with sepsis was evaluated. Methods. One hundred and four septic patients and 101 controls were enrolled. Receiver operating characteristic (ROC) analysis and multiple logistic regression were used to evaluate applicant markers for sepsis diagnosis. Markers with best Odds Ratio (OR) were combined, and the posttest probability and a composite score were computed. Results. Based upon ROC curves analysis, PCT, MR-proADM, IL-6, IL-10, TNF-α, and MCP-1 were considered applicant for sepsis diagnosis. Among these PCT, MR-proADM , IL-6, and TNF-α showed the best OR. A better posttest probability was found with the combination of PCT with MR-proADM and PCT with IL-6 or TNF-α compared to the single marker. A composite score of PCT, MR-proADM, and TNF-α showed the best ROC curve in the early diagnosis of sepsis. Conclusion. The combination of PCT with other markers should expedite diagnosis and treatment of sepsis optimizing clinical management. Hindawi Publishing Corporation 2015 2015-11-09 /pmc/articles/PMC4655267/ /pubmed/26635427 http://dx.doi.org/10.1155/2015/951532 Text en Copyright © 2015 Silvia Angeletti et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Angeletti, Silvia
Dicuonzo, Giordano
Fioravanti, Marta
De Cesaris, Marina
Fogolari, Marta
Lo Presti, Alessandra
Ciccozzi, Massimo
De Florio, Lucia
Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title_full Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title_fullStr Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title_full_unstemmed Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title_short Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination
title_sort procalcitonin, mr-proadrenomedullin, and cytokines measurement in sepsis diagnosis: advantages from test combination
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655267/
https://www.ncbi.nlm.nih.gov/pubmed/26635427
http://dx.doi.org/10.1155/2015/951532
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