Utilidad de la procalcitonina para predecir bacteriemia en pacientes oncológicos con fiebre

Abstract

AimBacteraemia is one of the most important causes of morbidity and mortality in cancer patients. The aim of this study was to evaluate the usefulness of procalcitonin for predicting bacteraemia in febrile oncology and oncohaematology patients admitted to the Emergency Department of our hospital. Material and methodsThe study included a total of 152 febrile episodes in 134 adult cancer patients. A blood sample was collected on admission to the Emergency Department to measure C-reactive protein (CRP) and procalcitonin (PCT). Febrile episodes were classified into two groups according to the blood culture results: bacteraemia episodes (n=22) and non-bacteraemia episodes (n=130). Receiver Operating Characteristic curve analysis was performed for each biomarker as a predictor of bacteraemia. ResultsPCT and CRP levels were significantly higher in the bacteraemia episodes group when compared with non-bacteraemia episodes group. PCT showed a diagnostic accuracy higher than CRP for predicting bacteraemia (AUC Receiver Operating Characteristic: PCT 0,781 (95% CI: 0,667-0,895) vs. CRP: 0,632 (95% CI: 0,493-0,771); p=0,02). A cut-off value of 0,20ng/mL was associated with a negative predictive value of 95,8% to rule-out bacteraemia. ConclusionPCT measurement in febrile cancer patients in the Emergency Department is a useful tool to rule-out bacteraemia, and may contribute in initial therapeutic decision making and rationalise the request for blood culture.