Should Procalcitonin Be Included in Acute Cholecystitis Guidelines? A Systematic Review

Yaow, Clyve Yu Leon; Chong, Ryan Ian Houe; Chan, Kwai S.; Chia, Christopher T.; Shelat, Vishal G

doi:10.3390/medicina59040805

Cited by 6 publications

(2 citation statements)

References 83 publications

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“…Several studies found CRP to be a good predictive factor for conversion; however, the cut-off values varied widely from 76 mg/L to 220 mg/L [5,[10][11][12][13]. Together with the valuable findings provided by ultrasound and CT exam, specific biomarkers were analyzed for the possible predictive role for the severity of local inflammation, such as the YKL-40 protein level [14], serum level of visfatin [15], procalcitonin [16], human neutrophil lipocalin [17], chitotriosidase, and neopterin [18]. However, their availability in emergencies is limited in many surgical departments.…”

Section: Introductionmentioning

confidence: 99%

The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis

Serban,

Stoica,

Dascalu

et al. 2023

JCM

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The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) to predict advanced inflammation, the risk for conversion, and postoperative complications in AC. Advanced AC was considered the cases with empyema, gangrene, perforation of the gallbladder, abscesses, or difficulties in achieving the critical view of safety. A 3-year retrospective was performed on 235 patients admitted in emergency care for AC. The NLR was superior to the PLR and SII in predicting advanced inflammation and risk for conversion. The best predictive value was found to be at an NLR “cut-off” value of >4.19, with a sensitivity of 85.5% and a specificity of 66.9% (AUC = 0.824). The NLR, SII, and TG 13/18 correlate well with postoperative complications of Clavien–Dindo grade IV (p < 0.001 for all variables) and sepsis. For predicting early postoperative sepsis, TG 13/18 grading >2 and NLR > 8.54 show the best predicting power (AUC = 0.931; AUC = 0.888, respectively), although not significantly higher than that of the PLR and SII. The NLR is a useful biomarker in assessing the severity of inflammation in AC. The SII and PLR may be useful in the prediction of systemic inflammatory response.

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Section: Introductionmentioning

confidence: 99%

The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis

Serban,

Stoica,

Dascalu

et al. 2023

JCM

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“…Only one patient had a PCT measurement, which was 83.86 ng/mL. It would be interesting to assess whether PCT is more sensitive in emphysematous hepatitis, as observed in hepatobiliary infections [ 16 ]. The diagnosis was based on a CT scan, sometimes associated with an ultrasound exam.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology

Porez,

Kallel,

Dobian

et al. 2023

Microorganisms

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Emphysematous hepatitis is a rare infectious disease, which corresponds to the presence of gas in the liver, without collection and after exclusion of vascular origin. This entity belongs to the group of emphysematous infections, whose physiopathology seems to be linked to the presence of unbalanced diabetes and to bacterial fermentation, leading to the production of gas within the liver parenchyma. Very few cases of emphysematous hepatitis have been described in the literature, and most of them had a rapidly fatal course. In this manuscript, we report the case of a 59-year-old man with emphysematous hepatitis due to wild-type Klebsiella pneumoniae that was successfully managed by surgery, and we perform a review of the literature to describe the clinical and biopathological aspects of this rare hepatic disease. Our manuscript underlines the need to perform biological and histopathological sampling to better understand the pathophysiology of this rare entity. The causes and mechanisms of emphysematous hepatitis, which seem to be multiple, lead us to believe that it is a syndrome rather than a simple infectious disease.

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Effectiveness of laboratory tests in predicting pathologies on computed tomography in geriatric patients with abdominal pain

Çatal,

Kır,

Genç

et al. 2024

Cukurova Medical Journal

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Purpose: Our study aimed to investigate the effectiveness of laboratory tests in predicting clinically significant pathologies (CSPs) on abdominal computed tomography (CT) in geriatric patients with abdominal pain. Materials and Methods: Our study is a retrospective case-control study. All patients who were admitted to the emergency department due to abdominal pain had an abdominal CT scan and were 65 years of age or older were included in the study. Laboratory test results were obtained from blood tests taken at the time of admission. According to CT results, patients were grouped into two groups: "CSPs (+)" or "CSPs (-)". The relationship between laboratory results and CSPs was analyzed statistically. Results: Five hundred eighteen patients were included in the study. CSPs (+) were detected on CT in 72.4% of the patients. Alkaline phosphatase (ALP), C-reactive protein (CRP), white blood cells (WBC), platelet, neutrophil, and neutrophil-lymphocyte ratio (NLR) values were statistically significantly higher in CSPs (+) patients. The optimal cut-off values of the tests were WBC>10.75 (x10˄3/µL), CRP >150.5 (mg/L), NLR>4.4, ALP >92 (U/L). The area under the receiver operating characteristic curve of all of these tests was below 0.6 and was not sufficiently effective for diagnostic use. Conclusion: Our study showed that using laboratory parameters alone would not be sufficient to predict CSPs on CT in geriatric patients with abdominal pain.

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Should Procalcitonin Be Included in Acute Cholecystitis Guidelines? A Systematic Review

Cited by 6 publications

References 83 publications

The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis

The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis

Diagnostic and Management of Emphysematous Hepatitis with Emphasis on Biopathology

Effectiveness of laboratory tests in predicting pathologies on computed tomography in geriatric patients with abdominal pain

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