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Annals of Intensive Care

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Open Access 01-12-2016 | Research

Prognostic value of procalcitonin in patients after elective cardiac surgery: a prospective cohort study

Authors: Matthias Klingele, Hagen Bomberg, Simone Schuster, Hans-Joachim Schäfers, Heinrich Volker Groesdonk

Published in: Annals of Intensive Care | Issue 1/2016

Abstract

Background

Procalcitonin (PCT) is a well-known prognostic marker after elective cardiac surgery. However, the impact of elevated PCT in patients with an initially uneventful postoperative course is still unclear. The aim of this study was to evaluate PCT levels as a prognostic tool for delayed complications after elective cardiac surgery.

Methods

A prospective study was performed in 751 patients with an apparently uneventful postoperative course within the first 24 h after elective cardiac surgery. Serum PCT concentration was taken the morning after surgery. All patients were screened for the occurrence of delayed complications. Delayed complications were defined by in-hospital death, intensive care unit readmission, or prolonged length of hospital stay (>12 days). Odds ratios (OR) [with 95% confidence interval (CI)] were calculated by logistic regression analyses and adjusted for confounders. Predictive capacity of PCT for delayed complications was calculated by ROC analyses. The cutoff value of PCT was derived from the Youden Index calculation.

Results

Among 751 patients with an initially uneventful postoperative course, 117 patients developed delayed complications. Serum PCT levels the first postoperative day were significantly higher in these 117 patients (8.9 ng/ml) compared to the remaining 634 (0.9 ng/ml; p < 0.001). ROC analyses showed that PCT had a high accuracy to predict delayed complications (optimal cutoff value of 2.95 ng/ml, AUC of 0.90, sensitivity 73% and specificity 97%). Patients with PCT levels above 2.95 ng/ml the first postoperative day had a highly increased risk of delayed complications (adjusted OR, 110.2; 95% CI 51.5–235.5; p < 0.001).

Conclusions

A single measurement of PCT seems to be a useful tool to identify patients at risk of delayed complications despite an initially uneventful postoperative course.

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Title: Prognostic value of procalcitonin in patients after elective cardiac surgery: a prospective cohort study
Authors: Matthias Klingele
Hagen Bomberg
Simone Schuster
Hans-Joachim Schäfers
Heinrich Volker Groesdonk
Publication date: 01-12-2016
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2016
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-016-0215-8

At a glance: The STEP trials

Springer Medicine

Prognostic value of procalcitonin in patients after elective cardiac surgery: a prospective cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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