{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:53:01Z","timestamp":1793829181905,"version":"4.6.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1481803520004029_sec_a1\"><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to describe the sensitivity of various C-reactive protein (CRP) cut-off values to identify patients requiring magnetic resonance imaging evaluation for pyogenic spinal infection among emergency department (ED) adults presenting with neck or back pain.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803520004029_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We prospectively enrolled a convenience series of adults presenting to a community ED with neck or back pain in whom ED providers had concern for pyogenic spinal infection in a derivation cohort from 2004 to 2010 and a validation cohort from 2010 to 2018. The validation cohort included only patients with pyogenic spinal infection. We analysed diagnostic test characteristics of various CRP cut-off values.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803520004029_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>We enrolled 232 patients and analysed 201 patients. The median age was 55 years, 43.8% were male, 4.0% had history of intravenous drug use, and 20.9% had recent spinal surgery. In the derivation cohort, 38 (23.9%) of 159 patients had pyogenic spinal infection. Derivation sensitivity and specificity of CRP cut-off values were &gt; 3.5 mg\/L (100%, 24.8%), &gt; 10 mg\/L (100%, 41.3%), &gt; 30 mg\/L (100%, 61.2%), and &gt; 50 mg\/L (89.5%, 69.4%). Validation sensitivities of CRP cut-off values were &gt; 3.5 mg\/L (97.6%), &gt; 10 mg\/L (97.6%), &gt; 30 mg\/L (90.4%), and &gt; 50 mg\/L (85.7%).<\/jats:p><\/jats:sec><jats:sec id=\"S1481803520004029_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>CRP cut-offs beyond the upper limit of normal had high sensitivity for pyogenic spinal infection in this adult ED population. Elevated CRP cut-off values of 10 mg\/L and 30 mg\/L require validation in other settings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2020.402","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T09:54:36Z","timestamp":1592214876000},"page":"836-843","source":"Crossref","is-referenced-by-count":10,"title":["Sensitivity of C-reactive protein cut-off values for pyogenic spinal infection in the emergency department"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4141-0738","authenticated-orcid":false,"given":"William T.","family":"Davis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"April","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeru","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-8869","authenticated-orcid":false,"given":"Brit","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Boys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Shroyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"S1481803520004029_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw191"},{"key":"S1481803520004029_ref12","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2016.1158314"},{"key":"S1481803520004029_ref24","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/S0140-6736(14)61233-2","article-title":"Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial","volume":"385","author":"Bernard","year":"2015","journal-title":"Lancet"},{"key":"S1481803520004029_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000544"},{"key":"S1481803520004029_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2010.02.004"},{"key":"S1481803520004029_ref13","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1742-6723.2011.01413.x","article-title":"Review article: how useful are laboratory investigations in the emergency department evaluation of possible osteomyelitis","volume":"23","author":"Harris","year":"2011","journal-title":"Emerg Med Australas"},{"key":"S1481803520004029_ref15","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.ajem.2010.05.004","article-title":"Low yield of ED magnetic resonance imaging for suspected epidural abscess","volume":"29","author":"El Sayed","year":"2011","journal-title":"Am J Emerg Med"},{"key":"S1481803520004029_ref4","unstructured":"4. 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