Prognostic Value of Procalcitonin, C-Reactive Protein, and Lactate Levels in Emergency Evaluation of Cancer Patients with Suspected Infection.
Patrick ChaftariAiham Z QdaisatAnne-Marie ChaftariJulian B MaamariZiyi LiFlorea LupuIssam RaadRay HachemGeorge CalinSai-Ching Jim YeungPublished in: Cancers (2021)
Cancer patients have increased risk of infections, and often present to emergency departments with infection-related problems where physicians must make decisions based on a snapshot of the patient's condition. Although C-reactive protein, procalcitonin, and lactate are popular biomarkers of sepsis, their use in guiding emergency care of cancer patients with infections is unclear. Using these biomarkers, we created a prediction model for short-term mortality in cancer patients with suspected infection. We retrospectively analyzed all consecutive patients who visited the emergency department of MD Anderson Cancer Center between 1 April 2018 and 30 April 2019. A clinical decision model was developed using multiple logistic regression for various clinical and laboratory biomarkers; coefficients were used to generate a prediction score stratifying patients into four groups according to their 14-day mortality risk. The prediction score had an area under the receiver operating characteristic curve value of 0.88 (95% confidence interval 0.85-0.91) in predicting 14-day mortality. The prediction score also accurately predicted intensive care unit admission and 30-day mortality. Our simple new scoring system for mortality prediction, based on readily available clinical and laboratory data, including procalcitonin, C-reactive protein, and lactate, can be used in emergency departments for cancer patients with suspected infection.
Keyphrases
- emergency department
- papillary thyroid
- intensive care unit
- squamous cell
- healthcare
- cardiovascular events
- public health
- risk factors
- newly diagnosed
- cardiovascular disease
- childhood cancer
- palliative care
- acute kidney injury
- ejection fraction
- chronic pain
- case report
- prognostic factors
- electronic health record
- quality improvement
- mechanical ventilation
- acute respiratory distress syndrome
- community acquired pneumonia