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Procalcitonin and C-Reactive Protein as an Early Predictor of Infection in Elective Gastrointestinal Cancer Surgery—a Prospective Observational Study

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Abstract

Background

Postoperative infections are a common entity following elective gastrointestinal surgery among which intra-abdominal infection is notorious and life threatening. Early detection could reduce postoperative morbidity and permit safe and early discharge. This study was aimed to establish the usefulness of procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day 3 as reliable markers for early detection of intra-abdominal infection and other postoperative infections following elective gastrointestinal cancer surgery.

Methods

A total of 125 patients following elective gastrointestinal cancer surgery were prospectively observed until discharge from January 2018 to December 2019. The incidence of intra-abdominal infections and other postoperative infections was recorded. Serum PCT and CRP were estimated on postoperative day 3 for all the patients. ROC analysis of PCT and CRP was performed to establish their predictability in detecting these infections. Risk factors for postoperative infections were also studied.

Results

The incidence of intra-abdominal infection (IAI) was 24%. The difference in PCT between the infected and non-infected patients was statistically significant (p = 0.001) but not in CRP (p = 0.223). On ROC analysis of CRP and PCT in detecting IAI, the areas under the curve were 0.494 and 0.615 respectively.

Conclusion

Raised serum PCT values on postoperative day 3 indicate the presence of infections and should prompt the surgeon to consider other investigations to confirm the presence of IAI and other postoperative infections and plan early intervention thus expediting the postoperative recovery.

Clinical Trial Registration Number

CTRI/2018/12/016695

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Availability of Data and Materials

Data will be provided if required by the editorial team.

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Funding

An intramural grant was obtained from the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER).

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Authors and Affiliations

  1. Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

    Ujjwal Das, Amaranathan Anandhi & Sathasivam Sureshkumar

  2. Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

    Apurba Shankar Sastry

  3. Department of Social and Preventive Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

    Lakshminarayanan Subitha

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  1. Ujjwal Das
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Contributions

Ujjwal Das: provision of study materials or patients; collection and assembly of data; formal analysis and interpretation; investigation; manuscript writing; final approval of the manuscript. Amaranathan Anandhi: conception and design; administrative support; supervision; manuscript writing; final approval of the manuscript. Sathasivam Sureshkumar: validation; supervision; writing review and editing; manuscript writing; final approval of the manuscript. Apurba Shankar Sastry: provision of study materials or patients; formal analysis; supervision; manuscript writing; final approval of the manuscript. Lakshminarayanan Subitha: data analysis and interpretation; supervision; manuscript writing; final approval of the manuscript. All the authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Amaranathan Anandhi.

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Ethics Approval

Approval was obtained from the Institute Ethics Committee (JIP/IEC/2017/0472).

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Informed consent was obtained from the patients before recruitment.

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Informed consent for publication was obtained from the patients before recruitment.

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The authors declare no competing interests.

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Das, U., Anandhi, A., Sureshkumar, S. et al. Procalcitonin and C-Reactive Protein as an Early Predictor of Infection in Elective Gastrointestinal Cancer Surgery—a Prospective Observational Study. J Gastrointest Canc 53, 605–613 (2022). https://doi.org/10.1007/s12029-021-00661-7

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  • DOI: https://doi.org/10.1007/s12029-021-00661-7

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