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Dis Markers. 2015;2015:795801. doi: 10.1155/2015/795801. Epub 2015 Mar 15.

Procalcitonin improves the Glasgow Prognostic Score for outcome prediction in emergency patients with cancer: a cohort study.

Author information

1
Medical University Department of the University of Basel, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
2
Medical University Department of the University of Basel, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland ; Institute of Psychology, University of Bern, Muesmatt, 3012 Bern, Switzerland.
3
University Clinic of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3, 3010 Bern, Switzerland.
4
Department of Laboratory Medicine, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
5
Emergency Department, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
6
Department of Clinical Nursing Science, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
7
Division of Hematology & Oncology, Medical University Department of the University of Basel, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland.

Abstract

The Glasgow Prognostic Score (GPS) is useful for predicting long-term mortality in cancer patients. Our aim was to validate the GPS in ED patients with different cancer-related urgency and investigate whether biomarkers would improve its accuracy. We followed consecutive medical patients presenting with a cancer-related medical urgency to a tertiary care hospital in Switzerland. Upon admission, we measured procalcitonin (PCT), white blood cell count, urea, 25-hydroxyvitamin D, corrected calcium, C-reactive protein, and albumin and calculated the GPS. Of 341 included patients (median age 68 years, 61% males), 81 (23.8%) died within 30 days after admission. The GPS showed moderate prognostic accuracy (AUC 0.67) for mortality. Among the different biomarkers, PCT provided the highest prognostic accuracy (odds ratio 1.6 (95% confidence interval 1.3 to 1.9), P < 0.001, AUC 0.69) and significantly improved the GPS to a combined AUC of 0.74 (P = 0.007). Considering all investigated biomarkers, the AUC increased to 0.76 (P < 0.001). The GPS performance was significantly improved by the addition of PCT and other biomarkers for risk stratification in ED cancer patients. The benefit of early risk stratification by the GPS in combination with biomarkers from different pathways should be investigated in further interventional trials.

PMID:
25861154
PMCID:
PMC4377367
DOI:
10.1155/2015/795801
[Indexed for MEDLINE]
Free PMC Article

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