Prediction of procalcitonin for postoperative intraabdominal infections after definitive operation of intestinal fistulae

详细信息    查看全文

• 作者：Huajian Ren ; MD^a ; Jianan Ren ; MD ; FACS^a ; ^b ; ^c ; ^{JiananR@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; ^{jan@medmail.com.cn" class="auth_mail" title="E-mail the corresponding author} ; Qiongyuan Hu ; MD^a ; ^b ; Gefei Wang ; MD^a ; ^b ; ^c ; Guosheng Gu ; MD^a ; Guanwei Li ; MD^c ; Xiuwen Wu ; MD^a ; Zhiwu Hong ; MD^a ; Jieshou Li ; MD^a
• 关键词：Procalcitonin ; Intraabdominal infections ; Intestinal fistulae surgery
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：206
• 期：2
• 页码：280-285
• 全文大小：411 K

文摘

Inflammatory biomarkers usually start to rise earlier before the infection becomes clinically evident. This study was designed to evaluate the predictive performance of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) counts in postoperative intraabdominal infections (IAIs) after definitive operation of intestinal fistulae.

Material and methods

We prospectively enrolled a total of 356 consecutive patients who underwent elective digestive tract reconstruction for gastrointestinal fistulae without existing clinical infection. Plasma PCT levels, serum CRP concentration, and WBC counts were assessed preoperatively and on postoperative days (PODs) 1, 3, 5, and 7. The predictive value of each laboratory marker for IAIs was calculated.

Results

The occurrence rate of IAIs after elective digestive tract reconstruction for gastrointestinal fistulae in our study was 7.3%. Both PCT levels and WBC counts were significantly higher in patients with IAIs than those in patients without IAIs on POD 1, POD 3, and POD 5, whereas CRP levels differed significantly on POD 3 and POD 5. Receiver-operating characteristics demonstrated that PCT on POD 3 had the highest diagnostic accuracy for IAIs, and the area under the curve reached 0.86, with a sensitivity of 92.0% and specificity of 74.0%.

Conclusions

The value of PCT above 0.98 ng/L on POD 3 and 0.83 ng/L on POD 5 could predict the occurrence of IAIs after definitive operations for intestinal fistulae.