PropertyValue
?:abstract
  • Study Objectives: Sepsis, the systemic response to infection, is a common but potentially life-threatening process that can be difficult to diagnose In the emergency department (ED), various measures, such as systemic inflammatory response syndrome (SIRS) and q-SOFA criteria, lactate, and procalcitonin, help determine sepsis and whether its source is bacterial However, there is currently no known marker that results in the ED to confirm diagnosis While delaying antibiotics for bacterial sepsis results in worse outcomes, giving unnecessary antibiotics is also harmful, so rapid, accurate diagnosis is critical Group II Secretory Phospholipase A2 (sPLA2-IIA) is a novel biomarker that has shown some promise in small studies as a tool to detect bacterial sepsis Our objective was to determine if a point-of-care (POC) sPLA2-IIA assay can predict sepsis in patients meeting SIRS/q-SOFA criteria Methods: Adult, non-pregnant patients who met SIRS and/or q-SOFA criteria and received a sepsis workup in a single tertiary academic ED were enrolled from May 2019 to March 2020, when the study was temporarily suspended under IRB guidance to reduce COVID-19 exposure Each time a lactate was drawn in the ED from an enrolled patient, a separate blood sample was collected simultaneously and run by a trained researcher on a POC machine to measure the sPLA2-IIA value Patients who were subsequently admitted to the ICU had additional sPLA2-IIA values drawn with lactates SPLA2-IIA data did not affect patient care, and the medical team was blinded to the results except when the researcher was also the primary physician for that patient in the ED Our primary endpoints were whether sPLA2-IIA could predict sepsis, bacterial sepsis, and bacteremia Secondary endpoints were ICU stay, hospital length of stay (LOS), in-hospital mortality, and 90-day mortality Potential confounders noted included elevated troponin, pancreatitis, antibiotic use at time of ED presentation, immunosuppression, steroid use, and comorbid inflammatory conditions Results: 226 patients ages 18-101 (mean 66) were analyzed, composed of 184 patients with sepsis (ED impression correct 80 5%), 152 with bacterial sepsis (ED impression correct 70 8%), and 37 with bacteremia See table for data on the ability of sPLA2-IIA to detect sepsis, bacterial sepsis, and bacteremia All patients with sPLA2-IIA>201 had a final diagnosis of sepsis, and all patients with sPLA2-IIA>225 had a final diagnosis of bacterial sepsis No significant difference was found after stratifying for potential confounders sPLA2-IIA was not found to be predictive of ICU stay, hospital LOS, or mortality Correlations between sPLA2-IIA and lactate (r=0 2688, p200 shows excellent specificity to detect sepsis and bacterial sepsis [Formula presented]
is ?:annotates of
?:creator
?:journal
  • Annals_of_Emergency_Medicine
?:license
  • unk
?:publication_isRelatedTo_Disease
?:source
  • WHO
?:title
  • 29 Bedside Point-of-Care Measurement of a Novel Biomarker SPLA2-IIA for Prediction of Sepsis: Midpoint Analysis
?:type
?:who_covidence_id
  • #898375
?:year
  • 2020

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