A panel comprising Serum Amyloid A, white blood cells and Nihss for the triage of patients at low risk of post-stroke infection

Article Article scientifique Article A panel comprising Serum Amyloid A, white blood cells and Nihss for the triage of patients at low risk of post-stroke infection eng 2021-06-10 2021-06-10 author Azurmendi Gil Leire 789106 author Krattinger Laura 691935 author Schweizer Juliane author Katan Mira author Sanchez Jean-Charles 0000-0002-8733-5932 24399 1070 10.3390/diagnostics11061070 34200779 2075-4418 PMC8230378 <p>Accurate and early prediction of poststroke infections is important to improve antibiotic therapy guidance and/or to avoid unnecessary antibiotic treatment. We hypothesized that the combination of blood biomarkers with clinical parameters could help to optimize risk stratification during hospitalization. In this prospective observational study, blood samples of 283 ischemic stroke patients were collected at hospital admission within 72 h from symptom onset. Among the 283 included patients, 60 developed an infection during the first five days of hospitalization. Performance predictions of blood biomarkers (Serum Amyloid-A (SAA), C-reactive protein, procalcitonin (CRP), white blood cells (WBC), creatinine) and clinical parameters (National Institutes of Health Stroke Scale (NIHSS), age, temperature) for the detection of poststroke infection were evaluated individually using receiver operating characteristics curves. Three machine learning techniques were used for creating panels: Associative Rules Mining, Decision Trees and an internal iterative-threshold based method called PanelomiX. The PanelomiX algorithm showed stable performance when applied to two representative subgroups obtained as splits of the main subgroup. The panel including SAA, WBC and NIHSS had a sensitivity of 97% and a specificity of 45% to identify patients who did not develop an infection. Therefore, it could be used at hospital admission to avoid unnecessary antibiotic (AB) treatment in around half of the patients, and consequently, to reduce AB resistance.</p> Antibiotic therapy Infection Panel of biomarkers Predictive algorithms Stroke Dewey 616 EMDO Stiftung

Dr. Julian Schweizer received funding from the EMDO foundation for protected research time for the this and other projects

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung M. Katan received this funding for protected research time for this and other projects Schweizerische Herzstiftung M. Katan received this funding for protected research time for this and other projects Baasch Medicus Foundation M. Katan received this funding for protected research time for this and other projects 56 Département de médecine 221 false 369 Biomarqueurs 635 Diagnostics 11 6 9ac885c8-9ba1-4970-87d0-c2b3a06905ff Article (Published version) Public Article-scientifique-from-europePmc.pdf 4086366 application/pdf CC BY openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Year	Views	Downloads

A panel comprising Serum Amyloid A, white blood cells and Nihss for the triage of patients at low risk of post-stroke infection	Diagnostics	2021	195	91
Validity and accuracy of posterior distributions in Bayesian statistics		2018	962	464

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