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Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer.

Methods

Prospective observational study including patients operated on for colorectal cancer between January and December of 2015 was performed. Serum PCT and CRP levels were measured before surgery and daily until postoperative day 3.

Results

One hundred twenty patients were included. Seven patients (5.8%) had PIAI. PCT levels were significantly higher in patients with PIAI on postoperative days 1 and 3, whereas CRP levels only were significantly more elevated on postoperative day 3. The ratio between CRP levels on postoperative day 3 and CRP levels on postoperative days 2 (CRP D3/CRP D2) and 1 (CRP D3/CRP D1) was significantly higher in patients with PIAI. PCT on postoperative day 3, for a cutoff of 0.45 ng/mL, had the best sensitivity (100%) with a specificity of 73.8%. The ratio CRP D3/CRP D1 yielded the higher specificity and positive predictive value (90.9 and 27.3%, respectively, for a cutoff of 1.8). The higher negative predictive value was obtained for PCT on postoperative days 1 and 3 (100%, with cutoff of 0.76 and 0.45 ng/mL, respectively) and for CRP on postoperative day 3 (100% with cutoff of 10 mg/dL).

Conclusion

PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.

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Grants

The work was financed with grants from the José Luis Castaño Foundation and from the Subdirección Xeral de Investigación da Xunta de Galicia.

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Authors and Affiliations

  1. Department of Surgery, Complejo Hospitalario de Pontevedra, Mourente s/n, 36071, Pontevedra, Spain

    E. Domínguez-Comesaña, S. M. Estevez-Fernández, J. Ballinas-Miranda & R. Domínguez-Fernández

  2. C/ Dr. Loureiro Crespo 57 20b, 36004, Pontevedra, Spain

    E. Domínguez-Comesaña

  3. Department of Biochemistry, Complejo Hospitalario de Pontevedra, Mourente s/n, 36071, Pontevedra, Spain

    V. López-Gómez

Authors
  1. E. Domínguez-Comesaña
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  2. S. M. Estevez-Fernández
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  3. V. López-Gómez
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  4. J. Ballinas-Miranda
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  5. R. Domínguez-Fernández
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Contributions

E.D-C participated in the design of the study and in the statistical analysis and wrote the manuscript.

V.L-G participated in the design of the study and made the biochemical analysis.

SM.E-F, R.D-F, and JB-M helped in the database and draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to E. Domínguez-Comesaña.

Ethics declarations

All patients provided written informed consent and the study was approved by the Regional Ethical Committee.

Conflict of interest

The authors declare that they have no conflict of interest.

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Domínguez-Comesaña, E., Estevez-Fernández, S.M., López-Gómez, V. et al. Procalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer. Int J Colorectal Dis 32, 1771–1774 (2017). https://doi.org/10.1007/s00384-017-2902-9

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  • DOI: https://doi.org/10.1007/s00384-017-2902-9

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