Procalcitonin applications management in the Biochemistry Emergency Laboratory
Gestión de las solicitudes de procalcitonina en el Laboratorio de Urgencias de Bioquímica
Autor
Rubio Sánchez, Ricardo
Lepe Balsalobre, Esperanza
Resumen
Procalcitonin (PCT) is one of the best diagnostic markers of bacterial infection. PCT results greater than 0.5 mg/L are indicative of sepsis; its levels being related to the severity and mortality of the infectious condition. All requests with a joint application for C-reactive protein (CRP) and PCT during 2017 were analyzed. In most cases, although CRP was higher than the established cut-off point, PCT values were less than 0.5 mg/L. The results showed that, if PCT was performed exclusively in patients with CRP greater than or equal to 20 mg/L, all patients susceptible to septic processes could be recruited. Because of this, we propose that PCT should not be performed if there is no CRP greater than 20 mg/L, except in cases where there is clinical suspicion of sepsis, in neonates and in samples from the Intensive Care Unit in which the determination would always be made. In the months studied, 21.53% of PCT applications should have been canceled. This would have meant not performing unnecessary tests and a better use of the resources present in the Biochemistry Emergency Laboratory. La procalcitonina (PCT) es uno de los mejores marcadores diagnósticos de infección bacteriana. Los resultados de PCT mayores de 0,5 mg/L son indicativos de sepsis, relacionándose sus niveles con la gravedad y la mortalidad del cuadro infeccioso. Se analizaron todas las peticiones con solicitud conjunta de proteína C reactiva (PCR) y PCT durante el año 2017. En la mayoría de los casos, aunque la PCR era superior al punto de corte establecido, los valores de PCT eran inferiores a 0.5 mg/L. Los resultados demostraron que, si la determinación de la PCT se realizaba de forma exclusiva en aquellos pacientes con PCR superior o igual a 20 mg/L, se conseguía reclutar a todos los pacientes susceptibles de proceso séptico. Debido a esto, proponemos que la PCT no se realice si no existe una PCR superior a 20 mg/L, excepto en los casos en los que exista sospecha clínica de sepsis, en neonatos y en muestras procedentes de la Unidad de Cuidados Intensivos en las que la determinación se realizaría siempre. En los meses estudiados se deberían haber anulado el 21.53% de las solicitudes de PCT. Esto hubiera supuesto la no realización de pruebas innecesarias y un mejor uso de los recursos presentes en el Laboratorio de Urgencias de Bioquímica.
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