LAUSR

BACKGROUND Researchers are debating if fecal calprotectin results are useful for infant patients, especially in screening for necrotizing enterocolitis (NEC). Currently, none of the FDA-approved calprotectin assays provide cut-offs for infant patients. We retrospectively analyzed data from a reference laboratory and university hospital to investigate if cut-offs could be established for infant patients. METHODS Data from a national reference laboratory of 5,144 test results for fecal calprotectin were analyzed for infant patients, and a cut-off was estimated based on the distribution of results. Additionally, a literature proposed cut-off of 226 μg/g was also considered. Validation of the cut-offs was attempted by review of the electronic medical record of our university hospital for 110 infant patients with orders for calprotectin. RESULTS Infants had a high percentage of elevated calprotectin results when using the adult cut-offs. A cut-off of 247 μg/g was estimated based on the reference laboratory results, which is similar to a literature proposed cut-off of 226 μg/g. However, the positive predictive value (PPV) for both cut-offs was <0.6 when retrospectively analyzing data from a university hospital. CONCLUSION Due to the low PPVs, the two infant-specific and assay-specific cut-offs would not be useful to screen for NEC in infants at our university hospital.