Procalcitonin levels do not predict mortality following major abdominal surgery

Szakmány, Tamás; Molnár, Zsolt

doi:10.1007/bf03018387

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…Similar results were drawn from other investigations [16, 18]. Very few studies failed to find the prognostic value [19]. At a cutoff of 10.64 ng/mL, procalcitonin measurements yielded a sensitivity of 76.2%, specificity of 81.7%, positive predictive value of 53.5%, negative predictive value of 67.8%, and an accuracy of 61.8% for differentiating nonsurvivors from survivors.…”

Section: Discussionsupporting

confidence: 84%

Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

Wang

Liu

et al. 2014

Mediators of Inflammation

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Objective. To investigate the prognostic significance of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT), N-terminal probrain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), cytokines, and clinical severity scores in patients with sepsis. Methods. A total of 102 patients with sepsis were divided into survival group (n = 60) and nonsurvival group (n = 42) based on 28-day mortality. Serum levels of biomarkers and cytokines were measured on days 1, 3, and 5 after admission to an ICU, meanwhile the acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated. Results. Serum sTREM-1, PCT, and IL-6 levels of patients in the nonsurvival group were significantly higher than those in the survival group on day 1 (P < 0.01). The area under a ROC curve for the prediction of 28 day mortality was 0.792 for PCT, 0.856 for sTREM-1, 0.953 for SOFA score, and 0.923 for APACHE II score. Multivariate logistic analysis showed that serum baseline sTREM-1 PCT levels and SOFA score were the independent predictors of 28-day mortality. Serum PCT, sTREM-1, and IL-6 levels showed a decrease trend over time in the survival group (P < 0.05). Serum NT-pro-BNP levels showed the predictive utility from days 3 and 5 (P < 0.05). Conclusion. In summary, elevated serum sTREM-1 and PCT levels provide superior prognostic accuracy to other biomarkers. Combination of serum sTREM-1 and PCT levels and SOFA score can offer the best powerful prognostic utility for sepsis mortality.

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Section: Discussionsupporting

confidence: 84%

Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

Wang

Liu

et al. 2014

Mediators of Inflammation

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“…This finding corresponds to results by Fritz et al (9), Wunder et al (11), and Novotny et al (12), who analyzed independent determinants of mortality in patients after cardiopulmonary bypass or with severe postoperative abdominal sepsis. On the other hand, an independent association of PCT with mortality was absent in two other series of polytrauma or abdominal surgery patients (8,10). In the first study by Hensler et al (8), the number of dying patients was presumably too low to allow detection of a significant effect.…”

Section: Prognostic Relevance Of Pct For Mortalitymentioning

confidence: 95%

“…Alternatively, PCT may be used as an unspecific prognostic tool to predict postoperative complications or death (5,6). Several studies have tried to find out whether PCT is an independent determinant of morbidity or mortality after polytrauma (7,8), cardiopulmonary bypass (9), or elective abdominal surgery (10) or in surgical sepsis (11,12). However, results have been inconsistent, depending on the underlying diagnosis, moment of PCT measurement, and type of outcome variable.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Procalcitonin for Outcome Prediction in Unselected Postoperative Critically Ill Patients

Schneider

Yilmaz²,

Kleespies³

et al. 2009

Shock

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The importance of postoperative procalcitonin (PCT) measurements for outcome prediction is currently controversial. Conflicting results have been obtained for patients after polytrauma, sepsis, peritonitis, or cardiac surgery and may result from incomplete adjustment for important confounders or from nonlinear PCT effects. We retrospectively analyzed the association of PCT concentration with postoperative mortality, morbidity, and length of stay in an unselected series of 220 consecutive patients who required postoperative intensive care unit therapy or surveillance. Biochemical markers were measured on the first day after intensive care unit admission. Results were adjusted for various confounding variables (Acute Physiology and Chronic Health Evaluation II score, underlying disease), and test accuracy was evaluated by receiver operating characteristic statistics. We found a significant nonlinear, logarithmic association between PCT concentration and outcome. After adjustment for relevant covariates, PCT was an independent determinant of mortality, combined mortality/morbidity, and postoperative hospital length of stay in survivors. At mortality analysis, the predictive power of PCT was superior to that of Acute Physiology and Chronic Health Evaluation II score and of IL-6 (optimal cutoff point, 1.44 ng/mL; sensitivity, 80.8%; specificity, 80.4%). The use of PCT was comparable to that of other prognostic markers when combined mortality/morbidity were examined. Our results suggest that PCT may deserve further testing as a prognostic tool in unselected, critically ill, surgical patients.

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“…They found that 30-day mortality was importantly elevated with PCT levels >0.5 ng/mL. On the other hand, Szakmary and Molnar revealed different data in their study [11]. They stated that ProCT levels do not yield enough clinical information relevant to mortality rates after major operations.…”

Section: Resultsmentioning

confidence: 92%

The Effects of Initial Procalcitonin Levels on Mortality Rates in Geriatric Patients Undergoing Surgery

Ipek

Karadeniz

Sitar

2020

Cureus

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Procalcitonin levels do not predict mortality following major abdominal surgery

Cited by 11 publications

References 4 publications

Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

Accuracy of Procalcitonin for Outcome Prediction in Unselected Postoperative Critically Ill Patients

The Effects of Initial Procalcitonin Levels on Mortality Rates in Geriatric Patients Undergoing Surgery

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