Use and usefulness of procalcitonin at the emergency department: a 6-month observational study from the University Hospital Centre Zagreb.

Authors

Domagoj Sajfert, Nika Rakuša, Ivana Lapić, Mirna Alvir, Ivan Gornik

Published in

Diagnosis (Berlin, Germany). Jul 14, 2026. Epub Jul 14, 2026.

Abstract

The aim of the study was to assess requesting patterns of procalcitonin in adult patients presenting at the Emergency Department (ED), evaluate usefulness of the obtained result on clinical decision-making process in terms of antibiotic prescriptions and determine its diagnostic accuracy for sepsis diagnosis.
Categories of patients in whom procalcitonin was requested were based on clinical, imaging and laboratory data, and were classified as follows: uncertain cause of fever in patients without major comorbidities, with cancer, in immunosupressed patients, evaluation of disease severity when infection is evident and unclear reason for testing. Usefulness of procalcitonin determination was evaluated by two senior physicians according to all available clinical data. Impact of procalcitonin results on decision-making process was assessed by analysis of antibiotic prescriptions. Diagnostic sensitivity and specificity of procalcitonin for sepsis diagnosis were determined at the cut-off of 2.0 μg/L.
Procalcitonin is mostly ordered due to unexplained fever, but in one third of patients is ordered with evident infection or for unclear reason. Procalcitonin was considered useful in 25 % of patients, regardless of the reason for determination (p=0.688). Patients were equally likely to receive antibiotic treatment, regardless of procalcitonin concentrations (p=0.846). Procalcitonin revealed 35 % sensitivity and 84 % specificity for sepsis diagnosis.
Despite frequent ordering of procalcitonin in patients with fever at the ED, the obtained result is not a decisive factor for further patient management. Procalcitonin alone has limited ability in distinguishing infectious from non-infectious causes of fever in patients presenting at the ED.

PMID:
42439046
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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