Scientific article
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English

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

Published inDiagnostics, vol. 11, no. 6, 1070
Publication date2021-06-10
First online date2021-06-10
Abstract

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.

Keywords
  • Antibiotic therapy
  • Infection
  • Panel of biomarkers
  • Predictive algorithms
  • Stroke
Funding
  • 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]
Citation (ISO format)
AZURMENDI GIL, Leire et al. A panel comprising Serum Amyloid A, white blood cells and Nihss for the triage of patients at low risk of post-stroke infection. In: Diagnostics, 2021, vol. 11, n° 6, p. 1070. doi: 10.3390/diagnostics11061070
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Article (Published version)
Identifiers
ISSN of the journal2075-4418
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Creation13/03/2022 10:45:00
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Update time04/10/2024 13:37:18
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