title: Serum lactate and procalcitonin measurements in emergency room for the diagnosis and risk-stratification of patients with suspected infection.
abstract: OBJECTIVE
  To study the contribution of lactate and procalcitonin (PCT) serum measurements for the diagnosis and the risk-stratification of patients with suspected infection presenting to the ED.
  
  
  METHODS
  Single-center one year observational study on 462 consecutive patients. Multivariate analysis to assess variables associated with sepsis, severe sepsis, septic shock and severe outcome.
  
  
  RESULTS
  Multivariate analysis (Odds ratio [95% CI]), showed that PCT was the best independent variable to identify sepsis (3.98 [2.60-6.10]), while lactate was the best to diagnose severe sepsis (10.88 [6.51-18.19]). Patients with both lactate above 2 mmol·L(-1) and PCT above 0.8 ng·mL(-1) had an enhanced risk of severe outcome.
  
  
  CONCLUSIONS
  the dosages of lactate and PCT are complementary for the diagnosis and risk-stratification of patients evaluated in the ED for suspected infection.
authors: Service d'Accueil des Urgences, Centre Hospitalier Universitaire (CHU) Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
authors: Yonathan
authors: Y
authors: Freund
authors: Samuel
authors: S
authors: Delerme
authors: Hélène
authors: H
authors: Goulet
authors: Maguy
authors: M
authors: Bernard
authors: Bruno
authors: B
authors: Riou
authors: Pierre
authors: P
authors: Hausfater
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D018570:Risk Assessment; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D019344:Lactic Acid; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide