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01-08-2013 | Original Article

Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery

Authors: Yuji Takakura, Takao Hinoi, Hiroyuki Egi, Manabu Shimomura, Tomohiro Adachi, Yasufumi Saito, Naoki Tanimine, Masashi Miguchi, Hideki Ohdan

Published in: Langenbeck's Archives of Surgery | Issue 6/2013

Abstract

Purpose

Surgical site infection (SSI) is a frequent complication of elective surgery for colorectal cancer. The classical clinical markers of infection—elevations in white blood cell count, C-reactive protein (CRP) level, and body temperature—do not precisely predict SSI after elective colorectal resection. The objective of this study was to evaluate the efficacy of procalcitonin (PCT) as a tool for diagnosis of SSI in elective surgery for colorectal cancer.

Methods

A total of 114 consecutive patients undergoing elective colorectal resection for cancer were evaluated. Routine blood samples, for determining PCT level, CRP plasma concentration, and white blood cell count, were obtained on postoperative days (POD) 1 and 3. Predictive values for each of the laboratory markers were examined.

Results

SSI was diagnosed in 18 (15.7 %) of 114 patients. Patients with SSI exhibited significantly higher PCT levels (on PODs 1 and 3) and CRP levels (on POD 3) than did patients without SSI. According to receiver operating characteristic analysis, PCT showed the highest area under the curve (AUC) for predicting SSI on both PODs 1 and 3 (AUC, 0.76 and 0.77, respectively). Multivariate logistic regression analysis showed that PCT (on PODs 1 and 3) was an independent predictor for SSI (odds ratio = 14.41 and 9.79, respectively).

Conclusion

Serum PCT is more reliable laboratory marker for the early diagnosis of SSI after elective colorectal cancer surgery, compared with conventional inflammatory indicators. PCT could serve as an additional diagnostic tool for the early identification of SSI to improve clinical decision making.

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Title: Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery
Authors: Yuji Takakura
Takao Hinoi
Hiroyuki Egi
Manabu Shimomura
Tomohiro Adachi
Yasufumi Saito
Naoki Tanimine
Masashi Miguchi
Hideki Ohdan
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 6/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-013-1095-0

At a glance: The STEP trials

Springer Medicine

Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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