How do bacteraemic patients present to the emergency department and what is the diagnostic validity of the clinical parameters; temperature, C-reactive protein and systemic inflammatory response syndrome?
- Authors:
-
- Lindvig, Katrine Prier ;
-
Henriksen, Daniel Pilsgaard
;
Close
0000-0003-1303-6195
Acute Medicine, Department of Clinical Research, Faculty of Health Sciences, SDU -
Nielsen, Stig Lønberg
;
Close0000-0002-7780-7131
Infectious Diseases, Department of Clinical Research, Faculty of Health Sciences, SDU - Jensen, Thøger Gorm ;
- Kolmos, Hans Jørn ;
- Pedersen, Court ;
-
Vinholt, Pernille Just
;
Close0000-0002-2035-0169
Clinical Biochemistry, Department of Clinical Research, Faculty of Health Sciences, SDU - Lassen, Annmarie Touborg
- DOI:
- 10.1186/1757-7241-22-39
- Abstract:
- OBJECTIVE: Although blood cultures are often ordered based on the presence of fever, it is a clinical challenge to identify patients eligible for blood cultures. Our aim was to evaluate the diagnostic value of temperature, C-reactive-protein (CRP), and Systemic Inflammatory Response Syndrome (SIRS) to identify bacteraemic patients in the Medical Emergency Department (MED). METHODS: A population-based cohort study including all adult patients at the MED at Odense University Hospital between August 1st 2009 - August 31st 2011. RESULTS: 11,988 patients were admitted to the MED within the study period. Blood cultures were performed on 5,499 (45.9%) patients within 2 days of arrival, of which 418 (7.6%) patients were diagnosed with bacteraemia. This corresponded to 3.5% of all patients. 34.1% of the bacteraemic patients had a normal rectal temperature (36.0°-38.0°C) recorded at arrival, 32.6% had a CRP < 100 mg/L and 28.0% did not fulfil the SIRS criteria.For a temperature cut-point of >38.0°C sensitivity was 0.64 (95% CI 0.59-0.69) and specificity was 0.81 (0.80-0.82) to identify bacteraemic patients. CONCLUSION: One third of the acute medical bacteraemic patients had a normal temperature at arrival to the MED. A normal temperature combined with a CRP < 100 mg/L and no SIRS criteria, ruled out bacteraemia.
- Type:
- Journal article
- Language:
- English
- Published in:
- Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2014, Vol 22, Issue 1
- Main Research Area:
- Medical science
- Publication Status:
- Published
- Review type:
- Peer Review
- Submission year:
- 2014
- Scientific Level:
- Scientific
- ID:
- 269167510
