PDF(Pubmed)
Abstract：
BACKGROUND: Early in the host-response to infection, neutrophils release calprotectin, triggering several immune signalling cascades. In acute infection management, identifying infected patients and stratifying these by risk of deterioration into sepsis, are crucial tasks. Recruiting a heterogenous population of patients with suspected infections from the emergency department, early in the care-path, the CASCADE trial aimed to evaluate the accuracy of blood calprotectin for detecting bacterial infections, estimating disease severity, and predicting clinical deterioration.
METHODS: In a prospective, observational trial from February 2021 to August 2022, 395 patients (n = 194 clinically suspected infection; n = 201 controls) were enrolled. Blood samples were collected at enrolment. The accuracy of calprotectin to identify bacterial infections, and to predict and identify sepsis and mortality was analysed. These endpoints were determined by a panel of experts.
RESULTS: The Area Under the Receiver Operating Characteristic (AUROC) of calprotectin for detecting bacterial infections was 0.90. For sepsis within 72 h, calprotectin\'s AUROC was 0.83. For 30-day mortality it was 0.78. In patients with diabetes, calprotectin had an AUROC of 0.94 for identifying bacterial infection.
CONCLUSIONS: Calprotectin showed notable accuracy for all endpoints. Using calprotectin in the emergency department could improve diagnosis and management of severe infections, in combination with current biomarkers.
BACKGROUND: DRKS00020521.
METHODS: In a prospective, observational trial from February 2021 to August 2022, 395 patients (n = 194 clinically suspected infection; n = 201 controls) were enrolled. Blood samples were collected at enrolment. The accuracy of calprotectin to identify bacterial infections, and to predict and identify sepsis and mortality was analysed. These endpoints were determined by a panel of experts.
RESULTS: The Area Under the Receiver Operating Characteristic (AUROC) of calprotectin for detecting bacterial infections was 0.90. For sepsis within 72 h, calprotectin\'s AUROC was 0.83. For 30-day mortality it was 0.78. In patients with diabetes, calprotectin had an AUROC of 0.94 for identifying bacterial infection.
CONCLUSIONS: Calprotectin showed notable accuracy for all endpoints. Using calprotectin in the emergency department could improve diagnosis and management of severe infections, in combination with current biomarkers.
BACKGROUND: DRKS00020521.
摘要：
背景：在宿主对感染的早期反应中，中性粒细胞释放钙卫蛋白，触发几个免疫信号级联。在急性感染管理中，识别感染患者，并根据恶化为败血症的风险对其进行分层，是关键任务。从急诊科招募有疑似感染的异类患者,在护理路径的早期，CASCADE试验旨在评估血钙卫蛋白检测细菌感染的准确性，估计疾病严重程度，并预测临床恶化。
方法：在前瞻性中，2021年2月至2022年8月的观察性试验,纳入了395例患者(n=194例临床疑似感染;n=201例对照).在登记时收集血样。钙卫蛋白识别细菌感染的准确性，并对脓毒症和死亡率进行了预测和鉴别分析。这些终点由专家小组确定。
结果：用于检测细菌感染的钙卫蛋白的接收器工作特征（AUROC）下的面积为0.90。对于72小时内的脓毒症，钙卫蛋白的AUROC为0.83。30天死亡率为0.78。在糖尿病患者中，钙卫蛋白用于鉴定细菌感染的AUROC为0.94。
结论：钙卫蛋白对所有终点均显示出显著的准确性。在急诊科使用钙卫蛋白可以改善严重感染的诊断和管理，结合当前的生物标志物。
背景：DRKS00020521。
方法：在前瞻性中，2021年2月至2022年8月的观察性试验,纳入了395例患者(n=194例临床疑似感染;n=201例对照).在登记时收集血样。钙卫蛋白识别细菌感染的准确性，并对脓毒症和死亡率进行了预测和鉴别分析。这些终点由专家小组确定。
结果：用于检测细菌感染的钙卫蛋白的接收器工作特征（AUROC）下的面积为0.90。对于72小时内的脓毒症，钙卫蛋白的AUROC为0.83。30天死亡率为0.78。在糖尿病患者中，钙卫蛋白用于鉴定细菌感染的AUROC为0.94。
结论：钙卫蛋白对所有终点均显示出显著的准确性。在急诊科使用钙卫蛋白可以改善严重感染的诊断和管理，结合当前的生物标志物。
背景：DRKS00020521。
