Reliability of Admission Procalcitonin Testing for Capturing Bacteremia Across the Sepsis Spectrum: Real-World Utilization and Performance Characteristics, 65 U.S. Hospitals, 2008–2017*
Authors' conclusion
At 65 study hospitals, procalcitonin-on-admission demonstrated poor sensitivity in ruling out BSI, moderate-to-poor discrimination for both bacteremic sepsis and occult BSI and did not appear to meaningfully alter empiric antibiotic usage.
Study context
- Population
- Adult inpatients (≥ 18 yr) with blood cultures and procalcitonin within 24 hours of admission, Cerner HealthFacts Database (2008–2017), 65 US hospitalsof 739,130 with admission blood cultures
- Participants
- 74,958 inpatients
- Outcome
- BSI detection by procalcitonin-on-admission
Methodological detailsmulticentre database
- Multicentre database
Main finding
As reported in the abstract
- Moderate discrimination at best for overall BSI (AUC 0.73; 95% CI 0.72-0.73); no additional utility in key subgroups
Observational data: associations, not effects.
Further findings
Empiric antibiotic use · admission
Procalcitonin testing frequency
- Admission procalcitonin testing among patients with admission blood cultures
- 10.1%
- No repeat procalcitonin test
- 83%
- Median procalcitonin varied considerably by pathogen, BSI source and acute illness severity
Empiric antibiotic use · admission
- Not different
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Reliability of Admission Procalcitonin Testing for Capturing Bacteremia Across the Sepsis Spectrum: Real-World Utilization and Performance Characteristics, 65 U.S. Hospitals, 2008–2017*. Crit Care Med. Published 3 July 2023. doi:10.
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