PTX3 predicts severe disease in febrile patients at the emergency department.
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.
de Kruif
Martijn D
MD
Department of Internal Medicine, Slotervaart Hospital, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands. m.d.dekruif@amc.uva.nl
Limper
Maarten
M
Sierhuis
Karlien
K
Wagenaar
Jiri F P
JF
Spek
C Arnold
CA
Garlanda
Cecilia
C
Cotena
Alessia
A
Mantovani
Alberto
A
ten Cate
Hugo
H
Reitsma
Pieter H
PH
van Gorp
Eric C M
EC
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
D015415:Biomarkers; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins