Izvorni znanstveni članak
Comparison of C-reactive protein and procalcitonin as predictors of postoperative infectious complications after elective colorectal surgery
Dagmar Oberhofer
; Department of Anesthesiology and Intensive Care, University Hospital Sveti Duh, Zagreb, Croatia
Josip Juras
; Department of Obstetrics and Gynecology, Clinical Hospital Centre Zagreb, Zagreb, Croatia
Ana Marija Pavičić
; Department of Anesthesiology and Intensive Care, University Hospital Sveti Duh, Zagreb, Croatia
Iva Rančić Žurić
; Department of Anesthesiology and Intensive Care, University Hospital Sveti Duh, Zagreb, Croatia
Vlatko Rumenjak
; Department of Medical Laboratory Diagnosis, University Hospital Sveti Duh, Zagreb, Croatia
Sažetak
Aim To assess diagnostic value of perioperative procalcitonin
(PCT) levels compared to C-reactive protein (CRP)
levels in early detection of infectious complications following
colorectal surgery.
Methods This prospective observational study included
79 patients undergoing elective colorectal surgery. White
blood cell count, CRP, and PCT were measured preoperatively
and on postoperative days (POD) 1, 2, 3, 5, and patients
were followed for postoperative complications. Diagnostic
accuracy of CRP and PCT values on each day was
analyzed by the receiver operating characteristics (ROC)
curve, with infectious complications as an outcome measure.
ROC curves with the largest area under the curve for
each inflammatory marker were compared in order to define
the marker with higher diagnostic accuracy.
Results Twenty nine patients (36.7%) developed infectious
complications. CRP and PCT concentrations increased in
the early postoperative period, with a significant difference
between patients with and without complications
at all measured postoperative times. ROC curve analysis
showed that CRP concentrations on POD 3 and PCT concentrations
on POD 2 had similar predictive values for the
development of infectious complications (area under the
curve, 0.746 and 0.750, respectively) with the best cut-off
values of 99.0 mg/L for CRP and 1.34 μg/L for PCT. Diagnostic
accuracy of CRP and PCT was highest on POD 5, however
the cut-off values were not considered clinically useful.
Conclusion Serial postoperative PCT measurements do
not offer an advantage over CRP measurements for prediction
of infectious complications following colorectal
surgery.
Ključne riječi
Hrčak ID:
95890
URI
Datum izdavanja:
15.12.2012.
Posjeta: 1.777 *