Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia

Tiewei Li; Xiaojuan Li; Zhiwei Zhu; Xinrui Liu; Geng Dong; Zhe Xu; Min Zhang; Ying Zhou; Jianwei Yang; Junmei Yang; Panpan Fang; Xiaoliang Qiao

doi:10.1080/07853890.2023.2185673

Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia

Ann Med. 2023 Dec;55(1):920-925. doi: 10.1080/07853890.2023.2185673.

Authors

Tiewei Li^{1

2}, Xiaojuan Li¹, Zhiwei Zhu¹, Xinrui Liu¹, Geng Dong¹, Zhe Xu¹, Min Zhang¹, Ying Zhou¹, Jianwei Yang¹, Junmei Yang¹, Panpan Fang¹, Xiaoliang Qiao³

Affiliations

¹ Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, P.R. China.
² The Center of Henan Children's Neurodevelopmental Engineering Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, P.R. China.
³ Center of Laboratory Medicine, Women & Infants Hospital of Zhengzhou, Zhengzhou, P.R. China.

Abstract

Background: It is possible that neonates with pneumonia also have unrecognized sepsis. Identifying sepsis in neonates with pneumonia may cause some trouble for clinicians. This study aimed to evaluate the clinical value of the procalcitonin-to-albumin ratio (PAR) in identifying sepsis in neonates with pneumonia.

Methods: We retrospectively included 912 neonates with pneumonia from January 2016 to July 2021. Clinical and laboratory data were collected from electronic medical records. Among neonates with pneumonia, 561 neonates were diagnosed with sepsis, according to the International Pediatric Sepsis Consensus. Neonates were divided into a sepsis group and a pneumonia group. A multivariate logistic regression analysis was used to evaluate whether PAR was a potential independent indicator for identifying sepsis in neonates with pneumonia. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of PAR in sepsis.

Results: Neonates with sepsis have a higher PAR (p < 0.001). Correlation analysis showed that PAR was positively correlated with the level of C-reactive protein (r = 0.446, p < 0.001). Multiple logistic regression analysis showed that PAR was an independent predictor of the presence of sepsis in neonates with pneumonia. ROC curve analysis revealed that PAR had good power in identifying sepsis in neonates with pneumonia (area under curve (AUC) = 0.72, 95% confidence interval (CI), 0.68-0.75, p < 0.001).

Conclusion: PAR can be used as a new biomarker to identify sepsis in neonates with pneumonia.

Keywords: Procalcitonin-to-albumin ratio; neonates; pneumonia; sepsis.

Plain language summary

Compared with neonates with pneumonia, neonates with both pneumonia and sepsis had a higher PAR.PAR was a useful biomarker in distinguishing septic neonates from neonates with pneumonia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

C-Reactive Protein / metabolism
Humans
Infant, Newborn
Pneumonia*
Procalcitonin
Prognosis
ROC Curve
Retrospective Studies
Sepsis* / diagnosis

Substances

C-Reactive Protein
Procalcitonin

Grants and funding

This work was supported by the Key Research, Development, and Promotion Projects of Henan Province (222102310067 and 222102310171), the Medical Science and Technology Project of Henan Province (LHGJ20210637, LHGJ20210665, LHGJ20210654, LHGJ20210672, LHGJ20210681, LHGJ20200633 and LHGJ20200666. Open Project of Henan Children’s Neurodevelopment Engineering Research Center.