儿童创伤患者术后败血症的降钙素原生物标志物:来自某三级大学医院的三年经验

IF 1.3 Q3 PEDIATRICS
Waleed H Albuali
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引用次数: 1

摘要

背景:生物标志物降钙素原(procalcitonin, PCT)在儿科创伤术后脓毒症的检测中具有良好的应用价值,特别是对脓毒症的高度怀疑,并能快速制定治疗方案。它的使用仍然局限于儿科外科患者,特别是重症监护病房(icu)的患者,他们更容易感染败血症。本研究的目的是了解降钙素原是否可以作为一种可靠和快速的生物标志物,用于儿科创伤患者术后脓毒症,并被带到PICU。方法:回顾性纵向研究于2017年1月至2019年12月进行。本研究纳入了因严重创伤或急性手术后事件而在法赫德国王大学医院PICU住院的> 2周大的术后儿童创伤患者。入院24小时内测量PCT水平,48-72小时后再次测量。结果:在我们的研究中,31%的重症患儿术后出现脓毒症。与PRISM III评分和24小时PCT水平相比,48-72小时PCT水平曲线下面积(AUC)最大。灵敏度为71%,特异性为65%,预测AUC值估计为0.71。48-72小时PCT水平的AUC为0.72(95%置信区间(CI): 0.65-0.79;P < 0.001),截止点> 0.10表明预测效度高,敏感性、特异性和阳性和阴性预测值分别为68.4%、63.6%、45.8%和81.8%。结论:PCT是检测小儿创伤术后脓毒症的一种敏感的生物标志物,尤其适用于检测前怀疑脓毒症较高的患者。此外,PCT可以单独使用,也可以与其他临床结果结合使用,以帮助制定对这类患者败血症的快速初步诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Procalcitonin Biomarker for Sepsis in Postoperative Pediatric Trauma Patients: Three Years of Experience from a Tertiary University Hospital.

Background: The biomarker procalcitonin (PCT) is good in detecting sepsis in postoperative pediatric trauma patients, especially those with a high suspicion of sepsis, and formulating a quick treatment. Its use is still limited to pediatric surgical patients, particularly those in intensive care units (ICUs), who are more susceptible to sepsis. The purpose of this study was to see if procalcitonin could be used as a reliable and quick biomarker for sepsis in postoperative pediatric trauma patients and were brought to the PICU.

Methods: This retrospective longitudinal study was conducted from January 2017 to December 2019. Postoperative pediatric trauma patients aged > 2 weeks old who were hospitalized at the PICU of King Fahd Hospital of the University due to serious trauma or post-acute surgical events were included. Within 24 hours of admission, PCT levels were measured, and again 48-72 hours later.

Results: In our study, 31% of severely ill children developed post-surgical sepsis. When compared to the PRISM III score and 24-hour PCT level, PCT levels at 48-72 hours exhibited the largest area under the curve (AUC). With a sensitivity of 71% and a specificity of 65%, the predictive AUC value was estimated to be 0.71. The AUC of PCT levels at 48-72 hours was 0.72 (95% confidence interval (CI): 0.65-0.79; p < 0.001), indicating high predictive validity using a cutoff point > 0.10, with sensitivity, specificity, and positive and negative predictive values of 68.4%, 63.6%, 45.8%, and 81.8%, respectively.

Conclusion: PCT is a sensitive biomarker for detecting sepsis in postoperative pediatric trauma patients, especially those with a high pre-test suspicion for sepsis. In addition, PCT can be used alone or in combination with other clinical findings to help formulate a rapid primary diagnosis of sepsis in this subset of patients.

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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
66
期刊介绍: Current Pediatric Reviews publishes frontier reviews on all the latest advances in pediatric medicine. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in pediatric medicine.
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