Pancreatic Stone Protein in Co-Evaluation with qSOFA and NEWS2 for Early Sepsis Detection at the Emergency Department.

IF 2.9 3区 医学 Q2 CRITICAL CARE MEDICINE
SHOCK Pub Date : 2025-09-25 DOI:10.1097/SHK.0000000000002720
Asimina Safarika, Georgia Damoraki, Konstantinos Katsaros, Soraya Hannane, Iwan Märki, Hiroaki Tanaka, George Giannikopoulos, Evangelos J Giamarellos-Bourboulis
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引用次数: 0

Abstract

Background: Prompt sepsis identification at emergency department (ED) triage is essential for timely treatment and improved outcomes. This study evaluated the diagnostic performance of pancreatic stone protein (PSP) in combination with the quick Sequential Organ Failure Assessment (qSOFA), and the National Early Warning Score (NEWS2) for early sepsis detection.

Methods: As part of the PROMPT study - a non-interventional, multicenter trial across six Greek hospitals - blood samples were collected within the first hour of ED admission. PSP levels were retrospectively assessed using nanofluidic near-patient immunoassay device (abioSCOPE, Abionic SA, Switzerland) in 362 adult patients with suspected infections and evaluated their qSOFA and NEWS2 scores. Objectives included evaluating qSOFA's performance, assessing the performance of PSP to identify high-risk patients with qSOFA ≤1, and determining the added value of combining PSP with qSOFA or NEWS2 (cut-off ≥7), using standard performance metrics.

Results: Among 156 sepsis cases, 128 (82.1%) had qSOFA scores ≤1. A qSOFA score ≥2 demonstrated a sensitivity of 17.9% and a specificity of 97.1%. In comparison, a qSOFA score of 1 showed a sensitivity of 44.2% and a specificity of 63.6%, while a score of 0 yielded a sensitivity of 37.8% and a specificity of 39.3%.The addition of PSP (cut-off: 300 ng/mL) to qSOFA ≤1 improved specificity to 94.0%, with a sensitivity of 14.8%-closely mirroring the performance of qSOFA ≥2. Similarly, combining PSP with NEWS2 <7 increased true positive cases from 34 to 52, enhancing sensitivity while maintaining high specificity.

Conclusion: This study highlights the utility of combining PSP level in the patient's blood with existing scoring systems to enhance early sepsis detection in high-risk ED patients. Future research will explore near-patient PSP measurements at ED triage to further refine and expedite sepsis management.

胰石蛋白与qSOFA和NEWS2在急诊科早期脓毒症检测中的联合评价
背景:在急诊科(ED)分诊时及时识别脓毒症对于及时治疗和改善预后至关重要。本研究评估胰石蛋白(PSP)与快速顺序器官衰竭评估(qSOFA)和国家早期预警评分(NEWS2)在早期败血症检测中的诊断价值。方法:作为PROMPT研究的一部分——一项在希腊六家医院进行的非介入性多中心试验——在急诊科入院的第一个小时内采集血液样本。采用纳米流体近患者免疫分析装置(abioSCOPE, Abionic SA,瑞士)回顾性评估362例疑似感染的成人患者的PSP水平,并评估其qSOFA和NEWS2评分。目的:评价qSOFA的疗效,评价PSP的疗效以识别qSOFA≤1的高危患者,并采用标准的疗效指标确定PSP联合qSOFA或NEWS2的附加价值(截止值≥7)。结果156例脓毒症患者中,qSOFA评分≤1者128例(82.1%)。qSOFA评分≥2时,敏感性为17.9%,特异性为97.1%。相比之下,qSOFA评分为1的敏感性为44.2%,特异性为63.6%,而评分为0的敏感性为37.8%,特异性为39.3%。在qSOFA≤1的基础上加入PSP(截止值:300 ng/mL),特异性提高到94.0%,敏感性为14.8%,与qSOFA≥2的表现非常接近。结论:本研究强调了将患者血液中PSP水平与现有评分系统相结合,以提高对高危ED患者脓毒症的早期检测。未来的研究将探索在急诊科分诊时近病人PSP测量,以进一步完善和加快败血症的管理。
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来源期刊
SHOCK
SHOCK 医学-外科
CiteScore
6.20
自引率
3.20%
发文量
199
审稿时长
1 months
期刊介绍: SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.
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