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Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis

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Abstract

Background

Ischemic and necrotic damages are complications of digestive diseases and require emergency management. Nevertheless, the decision to surgically manage could be delayed because of no sufficiently preoperative accurate marker of ischemia diagnosis, extension, and prognosis.

Methods

The aim of this study was to assess the predictive value of serum procalcitonin (PCT) levels for diagnosing intestinal necrotic damages, their extension, and their prognosis in patients with ischemic disease including ischemic colitis and mesenteric infarction by a gray zone approach. Between January 2007 to June 2014, 128 patients with ischemic colitis and mesenteric infarction (codes K55.0 and K51.9) were operated, for whom data on PCT were available. We perform a retrospective, multicenter review of their medical records. Patients were divided into subgroups: ischemia (ID group) versus necrosis (ND group); the extension [focal (FD) vs. extended (ED)] and the vital status [deceased (D) vs. alive (A)].

Results

PCT levels were higher in the ND (n = 94; p = 0.009); ED (n = 100; p = 0.02); and D (n = 70; p = 0.0003) groups. With a gray zone approach, the predictive thresholds were (i) for necrosis 2.473 ng/mL, (ii) for extension 3.884 ng/mL, and (iii) for mortality 7.87 ng/mL.

Conclusion

In our population, PCT could be used as a marker of necrosis; especially in case of extended damages and reflects the patient’s prognosis.

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Abbreviations

SB:

Small bowel

PCT:

Procalcitonin

CM:

Conservative management

SM:

Surgical management

Se:

Sensitivity

Sp:

Specificity

PPV:

Positive predictive value

NPV:

Negative predictive value

AUC:

Area under the curve

ROC:

Receiver operating curve

SD:

Standard deviation

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Disclosures

Cosse C, Sabbagh C, Browet F, Mauvais F, Rebibo L, Zogheib E, Chatelain D, Kamel S, and Regimbeau JM have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France

    C. Cosse, C. Sabbagh, L. Rebibo & J. M. Regimbeau

  2. INSERM U1088, Jules Verne University of Picardie, Amiens, France

    C. Cosse & S. Kamel

  3. Department of Digestive Surgery, Beauvais Hospital, Beauvais, France

    F. Browet & F. Mauvais

  4. Department of Anesthesiology, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France

    E. Zogheib

  5. Department of Pathology, Amiens North Hospital, University of Picardie, 80054, Amiens Cedex 01, France

    D. Chatelain

  6. Department of Biochemistry, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France

    S. Kamel

  7. EA4294, Jules Verne University of Picardie, Amiens, France

    J. M. Regimbeau

  8. Department of Digestive and Oncological Surgery, CHU Nord Amiens and University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France

    J. M. Regimbeau

  9. Clinical Research Center, Amiens University Hospital, Amiens, France

    J. M. Regimbeau

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  1. C. Cosse
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  2. C. Sabbagh
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  9. J. M. Regimbeau
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Correspondence to J. M. Regimbeau.

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Cosse, C., Sabbagh, C., Browet, F. et al. Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis. Surg Endosc 29, 3132–3139 (2015). https://doi.org/10.1007/s00464-014-4038-0

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  • DOI: https://doi.org/10.1007/s00464-014-4038-0

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