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Diagnostic reliability of the procalcitonin serum marker in septic frail patient

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Abstract

Aim

Aging is associated with increased inflammation, particularly in frailty. Indeed, such patient presents increased serum inflammatory markers, such as C-reactive protein and interleukin-6. Interleukin-6 is an important stimulating factor for the production of procalcitonin. The aim of this study is to evaluate the diagnostic reliability of serum PCT in the diagnosis of sepsis in frail elderly patients.

Methods

Using Fried’s criteria for frailty, 140 older patients hospitalized for any cause were consecutively enrolled and divided in two groups: no-frail (60 patients) and frail (80 patients). Patients were further categorized on the basis of the presence/absence of sepsis. Interleukin-6, procalcitonin and inflammatory indices were sampled at hospital admission.

Results

Septic patients from frail and no-frail groups showed higher values of interleukin-6 and procalcitonin. However, focusing on groups without sepsis, a statistically significant difference of interleukin-6 and procalcitonin values among frail and no-frail groups was seen at the post-hoc analysis. In frail group, procalcitonin cut-off of 0.5 ng/ml had a sensibility and specificity, respectively, of 100 and 22%. Through receiver operating characteristic curve (ROC) analysis, we found that procalcitonin serum value of 1.4 ng/ml had better sensibility and specificity (respectively, 93.8 and 84.4%, AUC 0.965).

Conclusions

In our study, we confirm the diagnostic reliability of procalcitonin in frail elderly patients for the diagnosis of sepsis. We found that 1.4 ng/ml was the best cut-off in this population.

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References

  1. Soysal P, Stubbs B, Lucato P et al. (2016) Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev 31:1–8

    Article  CAS  PubMed  Google Scholar 

  2. Franceschi C, Campisi J (2014) Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci 69(Suppl 1):S4–S9

    Article  PubMed  Google Scholar 

  3. Chen X, Mao G, Leng SX (2014) Frailty syndrome: an overview. Clin Interv Aging 9:433–441

    PubMed  PubMed Central  Google Scholar 

  4. Puzianowska-Kuznicka M, Owczarz M, Wieczorowska-Tobis K et al. (2016) Interleukin-6 and C-reactive protein, successful aging, and mortality: the PolSenior study. Immun Ageing 13:21

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Nasa P, Juneja D, Singh O (2012) Severe sepsis and septic shock in the elderly: an overview. World J Crit Care Med 1:23–30

    Article  PubMed  PubMed Central  Google Scholar 

  6. van Duin D (2012) Diagnostic challenges and opportunities in older adults with infectious diseases. Clin Infect Dis 54:973–978

    Article  PubMed  Google Scholar 

  7. Pilotto A, Dini S, Daragjati J et al. (2018) Combined use of the multidimensional prognostic index (MPI) and procalcitonin serum levels in predicting 1-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP): a prospective study. Aging Clin Exp Res 30:193–197

    Article  PubMed  Google Scholar 

  8. Meisner M (2014) Update on procalcitonin measurements. Ann Lab Med 34:263–273

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Serviddio G, Romano AD, Greco A et al. (2009) Frailty syndrome is associated with altered circulating redox balance and increased markers of oxidative stress. Int J Immunopathol Pharmacol 22:819–827

    Article  CAS  PubMed  Google Scholar 

  10. Washburn RA, Smith KW, Jette AM et al. (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162

    Article  CAS  PubMed  Google Scholar 

  11. Cong GT, Cohn MR, Villa JC et al. (2016) The Walking speed questionnaire: assessing walking speed in a self-reported format. J Orthop Trauma 30:e132–e137

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bone RC, Balk RA, Cerra FB et al. (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101:1644–1655

    Article  CAS  PubMed  Google Scholar 

  13. Tang H, Huang T, Jing J et al. (2009) Effect of procalcitonin-guided treatment in patients with infections: a systematic review and meta-analysis. Infection 37:497–507

    Article  CAS  PubMed  Google Scholar 

  14. Dahaba AA, Metzler H (2009) Procalcitonin’s role in the sepsis cascade. Is procalcitonin a sepsis marker or mediator? Minerva Anestesiol 75:447–452

    CAS  PubMed  Google Scholar 

  15. Lo Buglio A, Bellanti F, Talia M et al. (2016) Reliability of serum procalcitonin concentration for the diagnosis of sepsis in elderly patient with chronic kidney disease. J Gerontol Geriatr 64:49–54

    Google Scholar 

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Author notes

  1. Antonino Davide Romano and Aurelio Lo Buglio contributed equally to this work.

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Ce.R.M.I.-Centre for Aging Research, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy

    Antonino Davide Romano, Aurelio Lo Buglio, Francesco Bellanti, Rosanna Villani, Gaetano Serviddio & Gianluigi Vendemiale

Authors
  1. Antonino Davide Romano
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  2. Aurelio Lo Buglio
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  3. Francesco Bellanti
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  4. Rosanna Villani
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  5. Gaetano Serviddio
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  6. Gianluigi Vendemiale
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Contributions

ADR and AL contributed to conception, design, data analysis and drafting the work; FB and RV contributed in data collection and interpretation; GS and GV contributed in critical revision of the article.

Corresponding author

Correspondence to Antonino Davide Romano.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Romano, A.D., Lo Buglio, A., Bellanti, F. et al. Diagnostic reliability of the procalcitonin serum marker in septic frail patient. Aging Clin Exp Res 31, 727–732 (2019). https://doi.org/10.1007/s40520-018-1020-z

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  • DOI: https://doi.org/10.1007/s40520-018-1020-z

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