title: PTX3 predicts severe disease in febrile patients at the emergency department.
abstract: OBJECTIVE
  The long pentraxin PTX3 is a promising marker of disease severity in severely ill patients. In order to identify patients warranting critical care as quickly as possible, we investigated the value of PTX3 as a biomarker for disease severity in patients presenting with fever at the emergency department.
  
  
  METHODS
  Levels of PTX3 were measured in 211 febrile patients at the emergency and the levels were linked to markers of disease severity including admittance to a special care unit, bloodstream infection and congestive heart failure.
  
  
  RESULTS
  In comparison to median baseline levels of 2.30 ng/ml (interquartile range 1.66-3.67 ng/ml), levels of PTX3 were significantly elevated in patients admitted to the intensive-/medium care unit (median value 44.4 ng/ml, interquartile range 13.6-105.9 ng/ml) and in patients referred to the ward (median value 14.2 ng/ml, interquartile range 7.01-25.1 ng/ml). In addition, PTX3 was associated with duration of hospital stay and acute congestive heart failure. The levels were predictive for bloodstream infection (AUC=0.71; 95% CI 0.62-0.81).
  
  
  CONCLUSIONS
  PTX3 may be a useful marker for differentiation of patients with severe disease in patients presenting with fever to the emergency department.
authors: Department of Internal Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands. m.d.dekruif@amc.uva.nl
authors: Martijn D
authors: MD
authors: de Kruif
authors: Maarten
authors: M
authors: Limper
authors: Karlien
authors: K
authors: Sierhuis
authors: Jiri F P
authors: JF
authors: Wagenaar
authors: C Arnold
authors: CA
authors: Spek
authors: Cecilia
authors: C
authors: Garlanda
authors: Alessia
authors: A
authors: Cotena
authors: Alberto
authors: A
authors: Mantovani
authors: Hugo
authors: H
authors: ten Cate
authors: Pieter H
authors: PH
authors: Reitsma
authors: Eric C M
authors: EC
authors: van Gorp
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D004636:Emergency Service, Hospital; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D000683:Serum Amyloid P-Component / Q000032:analysis*; D012720:Severity of Illness Index; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins