Procalcitonin in Early Detection of Postoperative Complications

Abstract

Background: A prospective clinical study was performed to assess the accuracy of procalcitonin in 70 patients with elective colorectal or aortal surgery and to compare it with inflammatory mediators. Also the early prediction of complications and the outcome of these patients was taken into account. Methods: Laboratory variables and cytokine determination were obtained preoperatively, on the day of operation and postoperatively on a daily basis from day 1 to 5, and on days 7 and 10 in the colorectal group and in the aortal surgery group at different times on the operation day after aortal clamping. The main outcome criteria were early recognition of complications and alterations in the production of procalcitonin and cytokines in order to detect severe infective complications. Results: Procalcitonin was closely related to postoperative complications with significantly elevated levels at day 1 after surgery. The plasma concentrations of IL-6 increase on days 1–3 without a difference in the groups, also C-reactive protein demonstrates no differences. Conclusion: Procalcitonin presents itself as a new parameter of infection and sepsis. In the postoperative period PCT seems to be an interesting marker of early prediction of infective complications when high postoperative levels are found. Under routine conditions procalcitonin is a valid reproducible and detectable parameter.

Procalcitonin as an Acute Phase Marker

“…Reith et al 33 showed a marked increase in blood PCT, from 0·19 to I·2ltg/L, after uncomplicated surgery, whereas with complications the increase was from 0·36 to 6·9ltg/L. Meisner et «» showed that patients undergoing minor aseptic operations had increased plasma PCT in about one-third of cases, but seldom to levels above I j.tg/L.…”

Targeted metabolomics for discrimination of systemic inflammatory disorders in critically ill patients

“…The only marker widely accepted in the clinical setting is procalcitonin. However, procalcitonin remains controversial for differentiation of SIRS/sepsis because it has been described to be elevated after major surgery, a common cause of SIRS without underlying infection (10)(11)(12)(13)(14).…”

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

“…Moreover, a higher concentration of PCT correlates with more severe trauma and a higher incidence of various complications, including sepsis [22]. In the postoperative period following elective colorectal or aortal surgery, PCT seems to be a valuable early predictive marker of infective complications when high postoperative levels are found [25]. Although the association between PCT and elective colorectal surgery has been widely investigated [25,26], the predictive role of PCT levels on the prognosis of sepsis in the elderly following emergency colorectal surgery has not yet been investigated.…”