Receiver-Operating Characteristic Analysis of Leukocyte Counts and Serum C-Reactive Protein Levels in Children with Advanced Appendicitis

Surgery Today ◽  
2006 ◽  
Vol 36 (6) ◽  
pp. 515-518 ◽  
Author(s):  
Tatsuya Okamoto ◽  
Kaoru Sano ◽  
Keizo Ogasahara
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
C Reactive Protein ◽  
Characteristic Analysis ◽  
Protein Levels ◽  
Reactive Protein ◽  
Leukocyte Counts ◽  
Receiver Operating

scholarly journals Combined Analysis of C-reactive Protein in Pleural Fluid and Serum is Effective in the Differential Diagnosis of Exudative Pleural Effusions

2021 ◽  
Author(s):  
Shuo-yao Qu ◽  
Yong Zhang ◽  
Shuo Wu ◽  
Ming-ming Wang ◽  
Ling-li Liu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Receiver Operating Characteristic ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
C Reactive Protein ◽  
Characteristic Analysis ◽  
Combined Analysis ◽  
Reactive Protein ◽  
Receiver Operating

Abstract Background: Exudative pleural effusion (EPE) is one of the common pleural manifestations of various diseases. Differential diagnosis of EPE is imperative clinically as it identifies different causes of EPE, thereby, providing effective treatments. Thoracoscopy is a useful tool for differential diagnosis of EPE. However, some patients would refuse thoracoscopic examination due to its invasive nature. In addition, the specificity and sensitivity of existing routine tests of EPE are less satisfying. Therefore, there is a great need to establish an effective method for differential diagnosis of EPE.Methods: This study was a single-institution retrospective analysis of diagnostic efficiency of C-reactive protein (CRP) and procalcitonin (PCT) between March 2018 and September 2018. Eighty-seven patients diagnosed with EPE were enrolled. All patients underwent diagnostic thoracentesis. And the EPE was examined using biochemical, routine, microbiological, and cytological methods. Pathological cytology detection was of necessity for those with the suspicion of malignant PE. Benign PE comes from patients with pneumonia, empyema and tuberculosis. The levels of CRP and PCT of EPE and serum were measured before the treatment. Correlation analysis and receiver-operating characteristic (ROC) curve analysis were conducted to determine the underlying relationship between levels of CRP and PCT, and differential diagnosis.Results: Receiver operating characteristic analysis showed that the sensitivity and specificity for the analysis of pleural fluid CRP (p-CRP) are higher (cut-off: 17.55 pg/mL; sensitivity: 75.00 %, specificity: 83.90%) than that of serum CRP (s-CRP, cut-off: 23.90 pg/mL; sensitivity: 71.00 %, specificity: 80.4%) in the differential diagnosis for EPE. However, the analysis of pleural fluid PCT (p-PCT) and serum PCT (s-PCT) didn’t demonstrate correlations with EPE. Combined analysis of p-CRP (cut-off: 17.55 mg/dL) with s-CRP (cut-off: 23.9 pg/mL) showed the highest diagnostic accuracy (88.4%) in diagnosing infectious EPE.Conclusions: The data support the close relationship between combined analysis of p-CRP with s-CRP and effective and accurate differential diagnosis of EPE, due to its higher sensitivity and specificity. However, as a highly sensitive marker to diagnose bacterial infections, neither s-PCT nor p-PCT, showed correlations with the differential diagnosis of EPE.

scholarly journals 419. Diagnostic Utility of a Ferritin to Procalcitonin Ratio to Differentiate Patients with COVID-19 from Those with Bacterial Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S277-S277
Author(s):  
Katherine C Jankousky ◽  
Peter Hyson ◽  
Jin Huang ◽  
Daniel B Chastain ◽  
Carlos Franco-Paredes ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Host Response ◽  
Bacterial Pneumonia ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
University Hospital ◽  
Characteristic Analysis ◽  
The Us ◽  
Test Probability ◽  
Receiver Operating

Abstract Background Accurate, rapid, inexpensive biomarkers are needed to differentiate COVID-19 from bacterial pneumonia, allowing effective treatment and antibiotic stewardship. We hypothesized that the ratio of ferritin to procalcitonin (F/P) reflects greater viral activity and host response with COVID-19 pneumonia, while bacterial pneumonia would be associated with less cytolysis (lower ferritin) and more inflammation (higher procalcitonin), thus a lower F/P ratio. Methods We conducted a retrospective study of adult patients admitted to a single University hospital in the US through May 2020, during the COVID-19 pandemic. We compared F/P ratio of patients diagnosed with COVID-19 or bacterial pneumonia, excluding patients with COVID-19 and bacterial co-infections. In a logistic regression, we controlled for age, sex, body mass index (BMI), diabetes (DM), and hypertension (HTN). We used a receiver operating characteristic analysis to calculate the sensitivity and specificity of F/P values for the diagnosis of COVID-19 versus bacterial pneumonia. Results Of 218 patients with COVID-19 and 17 with bacterial pneumonia, COVID-19 patients were younger (56 vs 66 years, p=0.04), male (66% vs 24%, p=0.009), had higher BMI (31 vs 27 kg/m2, p=0.03), and similar rates of HTN (59% vs 45%, p=0.3) and DM (32% vs 18%, p=0.2). The median F/P ratio was significantly higher in patients with COVID-19 (3195 vs 860, p=0.0003, Figure 1). An F/P ratio cut-off of ≥ 1250 generated a sensitivity of 78% and a specificity of 59% to correctly classify a COVID-19 case (Figure 2). When adjusted for age, gender, BMI, DM, and HTN, a ratio ≥ of 1250 was associated with significantly greater odds of COVID-19 versus bacterial pneumonia (OR: 4.9, CI: 1.5, 16.1, p=0.009). Figure 1. Ferritin to Procalcitonin Ratios of patients with COVID-19 and patients with Bacterial Pneumonia (controls). Figure 2. Receiver Operating Characteristic Analysis of Ferritin to Procalcitonin Ratio Cut-off Values Predicting COVID-19 Diagnosis. Conclusion We observed an elevated F/P ratio in patients with COVID-19 compared to those with bacterial pneumonia. A F/P ratio ≥ 1250 provides a clinically relevant increase in pre-test probability of COVID-19. Prospective studies evaluating the discriminatory characteristics of F/P ratio in larger cohorts is warranted. Disclosures All Authors: No reported disclosures

scholarly journals A Promising New Predictive Factor for Detecting Bowel Resection in Childhood Intussusception: Lymphocyte-C Reactive Protein Ratio

2021 ◽  
Author(s):  
Bailin Chenilin Chen ◽  
Jian Cao ◽  
Chengwei Yan ◽  
Chao Zheng ◽  
Jingyu Chen ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Inflammatory Factors ◽  
C Reactive Protein ◽  
Intestinal Necrosis ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Receiver Operating

Abstract Background: The most critical concern for management of childhood intussusception is the bowel resection due to the intestinal ischemia and necrocis. It is of great importance for early prediction of this problem. We investigate the value of various combinations of inflammatory factors to predict the intestinal necrocis and resection.Methods: We retrospectively reviewed the medical records of pediatric patients with intussusception, which undergone surgical management. During the research period, 47 patients undergone intestinal resection due to intestinal necrocis and 68 patients without intestinal resection were enrolled. We evaluated the diagnostic values of various combination of inflammatory markers from preoperative period laboratory analyses using the receiver operating characteristic (ROC) method.Results: In the current cohort, 115 patients were operated for intussusception, among them, 47 patients (40.9%) undergone intestinal resections. In patients with intestinal resections, neutrophil count(p=0.013), CRP(p=0.002), platelet–lymphocyte ratio(PLR, p=0.008), NLR(neutrophil–lymphocyte ratio, p=0.026), and LCR(lymphocyte–CRP ratio, p<0.001) values were significantly higher than those in the patients without any resections. Receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in patients, with sensitivity of 0.82(0.73–0.86) and specifficity of 0.80(0.57–0.94) for the diagnosis of strangulation. Conclusion: The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.

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