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Procalcitonin (PCT) levels for ruling-out bacterial coinfection in ICU patients with influenza: A CHAID decision-tree analysis.

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Date

2015-12-15

Authors

Rodríguez, Alejandro H
Avilés-Jurado, Francesc X
Díaz, Emili
Schuetz, Philipp
Trefler, Sandra I
Solé-Violán, Jordi
Cordero, Lourdes
Vidaur, Loreto
Estella, Ángel
Pozo Laderas, Juan C

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Abstract

To define which variables upon ICU admission could be related to the presence of coinfection using CHAID (Chi-squared Automatic Interaction Detection) analysis. A secondary analysis from a prospective, multicentre, observational study (2009-2014) in ICU patients with confirmed A(H1N1)pdm09 infection. We assessed the potential of biomarkers and clinical variables upon admission to the ICU for coinfection diagnosis using CHAID analysis. Performance of cut-off points obtained was determined on the basis of the binominal distributions of the true (+) and true (-) results. Of the 972 patients included, 196 (20.3%) had coinfection. Procalcitonin (PCT; ng/mL 2.4 vs. 0.5, p  PCT has a high negative predictive value (94%) and lower PCT levels seems to be a good tool for excluding coinfection, particularly for patients without shock.

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Adult
Bacterial Infections
Biomarkers
Calcitonin
Calcitonin Gene-Related Peptide
Coinfection
Decision Trees
Female
Humans
Influenza, Human
Intensive Care Units
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Protein Precursors
Sensitivity and Specificity

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Keywords

CHAID analysis, Community-acquired pneumonia, Influenza A(H1N1)pmd, Procalcitonin, Prognosis, Respiratory coinfection, Septic shock

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