Early warning of bloodstream infection in elderly patients with monocyte count combined with procalcitonin
Objective To explore early warning markers of bloodstream infection in elderly patients.Methods The clinical data of suspected bloodstream infection patients over 65 years old who were treated in the second Medical Center of PLA General Hospital from August 2018 to August 2022 were collected retrospectively.C-reactive protein(CRP),procalcitonin(PCT),blood routine and other biomarkers were compared between bloodstream infection group and non-bloodstream infection group within 6 hours,days 2 and 14 of fever.Univariate and multivariate analyses were utilized to identify early warning factors of bloodstream infection in elderly patients.Receiver operating characteristic(ROC)curve analysis evaluated its value in early warning of bloodstream infection in elderly patients.Results A total of 209 patients were included,with 142 in the non-bloodstream infection group and 67 in the bloodstream group.Univariate analysis revealed significantly lower neutrophil count,lymphocyte count,monocyte ratio and count in the bloodstream infection group within 6 hours of fever(P<0.05).Neutrophil ratio,lymphocyte/monocyte(LMR)and PCT levels were significantly higher than those in non-bloodstream infection group(P<0.05).The PCT level of blood flow infection group was significantly higher than that of non-blood flow infection group on the 2nd and 14th day of fever,and there was no difference in other indexes between the two groups.Multivariate logistic regression analysis found that PCT(OR=6.008,95%CI=2.863～12.611,P<0.0001)combined with monocyte count(OR=4.468,95%CI=1.708～11.687,P=0.002)with an AUC of 0.779(0.705～0.852),P<0.001,sensitivity of 0.820,specificity of 0.670,positive predictive value of 0.782,and negative predictive value of 0.872.Conclusion The increase in PCT combined with the decrease in monocyte count predicts bloodstream infection in elderly patients within 6 hours of fever.
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