Procalcitonin and C-Reactive Protein as Early Indicators of Postoperative Intra-Abdominal Infection After Surgery for Gastrointestinal Cancer

Domínguez‐Comesaña, Elías; López-Gómez, Victoria; Estévez-Fernández, Sergio; Padin, Esther Mariño; Ballinas-Miranda, Julio; Carrera-Dacosta, Ester; Piñon-Cimadevila, Miguel Ángel; Barreiro-Morandeira, Francisco

doi:10.1016/j.cireng.2013.09.025

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…The AUC was 0.967 and specificity 53%. Other studies have not shown so high AUC for the SOFA score (6,18,19) probably because heterogeneous patient populations were involved, as opposed to our study which comprised fairly homogenous patient population. The obtained specificity for iSOFA was pretty low.…”

Section: Discussioncontrasting

confidence: 76%

Contribution of Presepsin, Procalcitonin and C-reactive protein to the SOFA Score in Early Sepsis Diagnosis in Emergency Abdominal Surgical Patients

2019

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This study examined whether the addition of biomarkers presepsin (PSEP), procalcitonin (PCT) and C-reactive protein (CRP) to the initial SOFA (iSOFA) score can improve diagnostic accuracy of early sepsis diagnosis in emergency abdominal surgery patients. Materials and Methods: Seventy-two study subjects had diagnosis of acute abdomen due to gastrointestinal disturbances. The study evaluated diagnostic accuracy and predictive value of two models (iSOFA only and iSOFA combined with three biomarkers) for sepsis diagnosis. Results: The AUC value for the iSOFA was highest, followed by the AUC value obtained for PSEP, PCT and CRP (0.989, 0.738, 0.694 and 0.606, respectively).The logistic regression analysis of the two models showed for the first model that patients with a higher iSOFA score are almost two times more likely to suffer from sepsis. In the second model, patients with a higher iSOFA score and a higher level of biomarkers are three times more likely to have sepsis. Conclusions: Although the SOFA score is known to be the best diagnostic tool for sepsis diagnosis, it seems that among the three investigated markers PSEP and PCTalthough not contributing to the iSOFA score-are good independent markers with significantly higher levels in septic than in non-septic patients. PSEP has the highest diagnostic accuracy for sepsis. Only the conventional marker CRP provides certain added value to the iSOFA score for sepsis prediction.Further investigations should be performed to study the possible diagnostic value of dynamic changes of the three examined markers in prediction and early diagnosis of sepsis.

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Section: Discussioncontrasting

confidence: 76%

Contribution of Presepsin, Procalcitonin and C-reactive protein to the SOFA Score in Early Sepsis Diagnosis in Emergency Abdominal Surgical Patients

2019

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“…Although a trend toward decreased postoperative mortality rate was observed [25,26] , the morbidity rates associated with the resection for extraperitoneal rectal cancer are still relatively high at 18-45% [25][26][27][28] . Among the various morbidities reported after resection for extraperitoneal rectal cancer, infectious complications remain a significant issue, despite technical and pharmacological efforts to address them.…”

Section: Discussionmentioning

confidence: 99%

Septic Complications after Resection for Middle or Low Rectal Cancer: Role of Gut Barrier Function and Inflammatory Serum Markers

Schietroma

Pessia²,

Colozzi³

et al. 2017

Dig Surg

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Background: The focus of this study was to understand the relationship between the failure of gut barrier function, inflammatory markers and septic complications after resection for extraperitoneal rectal cancer. Methods: One hundred seven patients were enrolled into this prospective observational study and underwent open colorectal resection for extraperitoneal cancer. All patients underwent an assessment of intestinal permeability (L/M ratio), endotoxemia, interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP) and elastase levels before surgery and on postoperative days 1, 3, and 7. Results: Septic complications developed in 23.3% of patients. There were no significant differences in preoperative L/M ratio, endotoxine, CRP, interleukin-1 (IL-1), IL-6, and elastase levels between septic and non-septic groups. All patients showed a significant increase in intestinal permeability, endotoxemia, IL-1, IL-6, CRP, and elastase on the first postoperative day. At postoperative day 7, the septic group continued to demonstrate an increase in intestinal permeability, endotoxemia and elastase and significant difference was observed between the 2 groups (p < 0.05), whereas there was no significant difference in IL-1, IL-6, and CRP levels. Conclusion: The pattern of change in the postoperative period of intestinal permeability, systemic endotoxemia and elastase concentration is significantly higher in patients in whom sepsis develops, while the concentration of IL-1β, IL-6, and CRP does not permit to distinguish infection from inflammation.

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“…Signs of hypoperfusion and hypotension including oliguria, lactic acidosis, and acute alteration of mental status are indicative of ongoing sepsis [30]. Some researchers have assessed the predictive value of C-reactive protein (CRP) for postoperative intra-abdominal sepsis [31,32,33]. Typically, CRP peaks between postoperative day (POD) 2 and POD 3 (about 12-24 h after interleukin [IL]-6 peaks) and declines to baseline level on POD 5 [33].…”

Section: Literature Reviewmentioning

confidence: 99%

Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?

Alzerwi

2022

Postępy Higieny I Medycyny Doświadczalnej

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The present paper was done to review common diagnostic techniques used to help surgeons find the most suitable way to diagnose postoperative intra-abdominal sepsis (IAS). The topic was searched on MEDLINE, Embase, and Cochrane Library databases. Collected articles were classified and checked for their quality. Findings of selected research were included in this study and analyzed to find the best diagnostic method for intra-abdominal sepsis. IAS presents severe morbidity and mortality, and its early diagnosis can improve the outcome. Currently, there is no consensus among surgeons on a single diagnostic modality that should be used while deciding reoperation in patients with postoperative IAS. Though it has a high sensitivity for abdominal infections, computed tomography has limited applications due to mobility and time constraints. Diagnostic laparoscopy is a safe process that produces usable images, and can be used at the bedside. Diagnostic peritoneal lavage (DPL) has high sensitivity, and the patients testing positive through DPL can be subjected to exploratory laparotomy, depending on severity. Abdominal Reoperation Predictive Index (ARPI) is the only index reported as an aid for this purpose. Serial intra-abdominal pressure measurement has also emerged as a potential diagnostic tool. A proper selection of diagnostic modality is expected to improve the outcome in IAS, which presents high mortality risk and a limited time frame.

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Procalcitonin and C-Reactive Protein as Early Indicators of Postoperative Intra-Abdominal Infection After Surgery for Gastrointestinal Cancer

Cited by 9 publications

References 30 publications

Contribution of Presepsin, Procalcitonin and C-reactive protein to the SOFA Score in Early Sepsis Diagnosis in Emergency Abdominal Surgical Patients

Contribution of Presepsin, Procalcitonin and C-reactive protein to the SOFA Score in Early Sepsis Diagnosis in Emergency Abdominal Surgical Patients

Septic Complications after Resection for Middle or Low Rectal Cancer: Role of Gut Barrier Function and Inflammatory Serum Markers

Diagnostic challenges in postoperative intra-abdominal sepsis in critically ill patients: When to reoperate?

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