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Clinical Utility of the Serum Amyloid A Test for the Diagnosis of Bacterial Infections in Patients Visiting the Emergency Room

 Jeongyun Bae  ;  Min Hyuk Choi  ;  Yongjung Park  ;  Jeong-Ho Kim 
 Journal of Laboratory Medicine and Quality Assurance(임상검사와 정도관리), Vol.45(4) : 156-165, 2023-12 
Journal Title
Journal of Laboratory Medicine and Quality Assurance(임상검사와 정도관리)
Issue Date
Serum amyloid A protein ; Bacterial infections ; C-reactive protein ; Acute-phase proteins ; Emergency room
Background: Currently, acute-phase proteins, such as serum amyloid A (SAA) and C-reactive protein (CRP), and the erythrocyte sedimentation rate (ESR) test are used for the diagnosis of infectious or inflammatory diseases. This study determined whether the SAA test is useful for diagnosing bacterial infections in patients visiting the emergency room (ER).

Methods: The medical records of 1,400 patients who visited the ER of Gangnam Severance Hospital from February to December 2022 were retrospectively analyzed. The groups of patients were divided based on clinical diagnoses, and the usefulness of SAA and other tests, including CRP, ESR, and complete blood count indices, in diagnosing bacterial infections was estimated.

Results: The serum levels of SAA and CRP were well correlated, showing a Spearman’s correlation coefficient of 0.844. In a multivariate analysis, SAA was identified as an independent factor associated with bacterial infections, along with other variables such as the patient’s timing of the ER visit after 24 hours of symptom onset, body temperature, platelet distribution width, neutrophil count, and ESR. However, CRP did not exhibit a significant association. As a result of the receiver operating characteristic curve analysis, the area under the curve values of SAA, CRP, and the combination of SAA+CRP+ESR+neutrophil count for the diagnosis of bacterial infection were 0.840, 0.834, and 0.848, respectively, without showing statistically significant differences with each other.

Conclusions: The SAA test would independently help diagnose bacterial infections in patients visiting the ER.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jeong Ho(김정호) ORCID logo https://orcid.org/0000-0003-2479-0548
Park, Yong Jung(박용정) ORCID logo https://orcid.org/0000-0001-5668-4120
Choi, Min Hyuk(최민혁) ORCID logo https://orcid.org/0000-0001-9801-9874
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