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pISSN 2950-9114 eISSN 2950-9122
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Original Article

Lab Med Qual Assur 2023; 45(4): 156-165

Published online December 31, 2023


Copyright © Korean Association of External Quality Assessment Service.

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

Jeongyun Bae1,2 , Min Hyuk Choi2 , Yongjung Park2 , and Jeong-Ho Kim3

1Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine; 2Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; 3Department of Laboratory Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea

Correspondence to:Yongjung Park
Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea
Tel +82-2-2019-3533
E-mail ypark119@yuhs.ac

Received: September 8, 2023; Revised: October 10, 2023; Accepted: October 11, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Keywords: Serum amyloid A protein, Bacterial infections, C-reactive protein, Acute-phase proteins, Emergency room

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