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The Role of Mid-Regional Proadrenomedullin in the Differential Diagnosis between Culture-Negative and Culture-Positive Sepsis at Emergency Department Admission.
Mearelli, Filippo; Barbati, Giulia; Spagnol, Francesca; Nunnari, Alessio; Castello, Luigi Mario; Lupia, Enrico; Muiesan, Maria Lorenza; Di Somma, Salvatore; Avanzi, Gian Carlo; Biolo, Gianni.
Afiliación
  • Mearelli F; Unit of Internal Medicine, Department of Medical Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
  • Barbati G; Biostatistics Unit, Department of Medical Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
  • Spagnol F; Unit of Internal Medicine, Department of Medical Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
  • Nunnari A; Unit of Internal Medicine, Department of Medical Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
  • Castello LM; Unit of Emergency Medicine, Department of Translational Medicine Eastern Piedmont, University of Novara, Corso Giuseppe Mazzini 18, 28100 Novara, Italy.
  • Lupia E; Unit of Emergency Medicine, Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
  • Muiesan ML; Unit of Internal Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
  • Di Somma S; Unit of Emergency Medicine, Department of Medical Surgery Sciences and Translational Medicine, University "Sapienza" of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy.
  • Avanzi GC; Unit of Emergency Medicine, Department of Translational Medicine Eastern Piedmont, University of Novara, Corso Giuseppe Mazzini 18, 28100 Novara, Italy.
  • Biolo G; Unit of Internal Medicine, Department of Medical Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
Biomedicines ; 10(2)2022 Feb 01.
Article en En | MEDLINE | ID: mdl-35203566
BACKGROUND: The host response in culture-negative sepsis (CnS) has been marginally explored upon emergency department (ED) admission. It would be of paramount importance to create a clinical prediction rule to support the emergency department physician in identifying septic patients who can be treated with antibiotics immediately without waiting time to draw cultures if they are unlikely to provide useful diagnostic information. METHODS: A multivariable logistic regression analysis was applied to identify the independent clinical variables and serum biomarkers of the culture-negative status among 773 undifferentiated septic patients. Those predictors were combined to build a nomogram predictive of CnS. RESULTS: The serum concentrations of six biomarkers, among the eight biomarkers assayed in this study, were significantly lower in the patients with CnS (449) than in those with culture-positive sepsis (324). After correction for co-variates, only mid-regional proadrenomedullin (MR-proADM) was found to be independently correlated with culture-negative status. Absence of diabetes, hemoglobin concentrations, and respiratory source of infection were the other independent clinical variables integrated into the nomogram-its sensitivity and specificity for CnS were 0.80 and 0.79, respectively. CONCLUSIONS: Low concentrations of MR-proADM were independently associated with culture-negative sepsis. Our nomogram, based on the MR-proADM levels, did not predict culture-negative status with reasonable certainty in patients with a definitive diagnosis of sepsis at ED admission.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Biomedicines Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Biomedicines Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza