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Soluble triggering receptor expressed on myeloid cells-1 as an infection marker for patients with neutropenic fever.

Abstract：

OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECTS:Seventy-five patients with neutropenic fever after chemotherapy for their hematologic malignancies. INTERVENTION:None. MEASUREMENTS AND MAIN RESULTS:A total of 137 episodes of neutropenic fever in 75 patients were classified into 75 episodes of documented infections and 62 low likelihood of infection. The level of soluble triggering receptor expressed on myeloid cells-1 was significantly elevated in the group of documented infection. The area under the receiver operating characteristic curve for the diagnosis of infection was 0.719 (95% confidence interval, 0.632-0.806; p < .0001) for soluble triggering receptor expressed on myeloid cells-1, which was larger than the values of 0.501 for procalcitonin (0.465-0.657; p = .218) and 0.491 for C-reactive protein (0.394-0.589, p = .858). The fitted marginal logistic regression model of all episodes contained two statistically significant predictors of infection: soluble triggering receptor expressed on myeloid cells-1 (per 1-pg/mL increase; odds ratio [OR], 1.0002; 95% CI, 1.0001-1.0003; p < .0001) and procalcitonin (per 1-ng/mL increase; OR, 1.0094; 95% CI, 1.0005-1.0184; p = .0002). In a diagnostic panel with soluble triggering receptor expressed on myeloid cells-1 and procalcitonin, the sensitivity and specificity were 88% and 48%, respectively. CONCLUSIONS:Soluble triggering receptor expressed on myeloid cells-1 is better than procalcitonin in the prediction of infection at the onset of neutropenic fever. By applying soluble triggering receptor expressed on myeloid cells-1 and procalcitonin together, low or high risk for infection can be defined at the onset of neutropenic fever.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Lin CH,Yao M,Hsu SC,Ho CC,Lin MT,Lin CA,Hu FC,Yu CJ,Tien HF

doi

10.1097/CCM.0b013e31820a92dc

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

993-9

issue

eissn

0090-3493

issn

1530-0293

journal_volume

pub_type

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Soluble triggering receptor expressed on myeloid cells-1 as an infection marker for patients with neutropenic fever.