Evidence map›Paper›PMID 33753971›Full record

ArticleEJIFCC2021

Procalcitonin (PCT) Level in the Emergency Department Identifies a High-Risk Cohort for All Patients Treated for Possible Sepsis.

Georgia Lucas, Angela Bartolf, Nicholas Kroll, Agampodi-Umanda De Thabrew, Zoya Murtaza, Siddarth Kumar, Abrar Gani, Andrea Annoni, Marie Parsons, Helen Pardoe

Open access · greenAbstract read
In one paragraph

Article in EJIFCC, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Georgia LucasPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Angela BartolfPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Nicholas KrollPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Agampodi-Umanda De ThabrewPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Zoya MurtazaPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Siddarth KumarPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Abrar GaniPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Andrea AnnoniPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Marie ParsonsPrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Helen PardoePrincess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Princess Alexandra Hospital NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

WHAT IS ALREADY KNOWN?: The benefits of measuring PCT in the Emergency Department (ED) are not yet fully characterised.PCT is widely used in the intensive care setting to guide antimicrobial prescribing. WHAT THIS ADDS?: Measurement of PCT as a routine in the emergency department for all patients treated for possible sepsis identifies a high-risk cohort. KEY IMPROVEMENT IN PATIENT CARE: A PCT measurement of >0.2ug/L in the Emergency Department identifies a patient at increased risk of deterioration and of in-hospital death.

backgroundEarly recognition and management of sepsis in the Emergency Department (ED) is a clinical challenge. Our aim was to determine if measuring the biomarker PCT in patients with suspected sepsis enables the identification of patients at increased risk of deterioration or in-hospital death in the ED setting of a district general hospital in the United Kingdom.

methodsA prospective observational study was conducted on all patients aged 18 and over presenting to ED fulfilling NICE criteria for moderate to high risk of sepsis admitted to hospital. Patients had a PCT test alongside the sepsis six protocol. PCT was measured using Brahms's chemiluminescent micro particle assay (CMIA) for the quantitative determination of PCT in human serum and plasma on the Abbott Alinity I analytical platform. The cost per test was approximately 13 GBP.The analysis was performed on patients having a PCT in ED over a 7-month period, with in-depth scrutiny of an appropriate subgroup. A high level quality improvement (QI) approach was used in the study.

resultsA total of 1242 patients were included in the study. Mean/median age was 67.9/72, (range 18-102). 88.7% of deaths occurred in patients over 65 years of age. 42.4% (n=532) had a PCT level in ED of >0.2 ug/L. This identified a high risk group with a 2.4 fold increase in mortality rate (7.7%:18.2% p value <0.001). The median length of stay (LOS) was 5 (IQR 9) and 8 days (IQR 11) in patients with a first PCT of ≤0.2 ug/L versus >0.2 ug/L respectively.

conclusionAn immediate PCT on patients presenting to ED with signs of sepsis in a non-specialised acute trust identifies those patients at an increased risk of deterioration and in hospital death.

Indexed as

emergency departmenthigh-riskprocalcitonin

Identifiers

PMID33753971
PMCPMC7941056
OpenAlexW3136317651

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.