Abstract | HYPOTHESIS: DESIGN: Prospective, international, multicenter inception cohort study. SETTING: Five European surgical referral centers. PATIENTS: Eighty-two patients with intraoperatively proven secondary peritonitis were enrolled within 96 hours of symptom onset. MAIN OUTCOME MEASURES: RESULTS:
Procalcitonin concentrations were most closely correlated with the development of septic multiorgan dysfunction syndrome ( MODS), with peak levels occurring early after symptom onset or during the immediate postoperative course. No such correlation was observed for CRP. According to receiver operating characteristic analysis, a procalcitonin value of 10.0 ng/mL or greater on 2 consecutive days was superior to a CRP level of 210 mg/L or greater for predicting septic MODS, with sensitivity, specificity, and positive and negative predictive values of 65%, 92%, 83%, and 81% for procalcitonin and 67%, 58%, 49%, and 74% for CRP, respectively (P<.001). Assessment of septic MODS was already possible on the first 2 postoperative days, with similar sensitivity and specificity. Persisting procalcitonin levels greater than 1.0 ng/mL beyond the first week after disease onset strongly indicated nonsurvival and were significantly better than CRP in assessing overall prognosis (P<.001). CONCLUSIONS:
Procalcitonin monitoring is a fast and reliable approach to assessing septic MODS and overall prognosis in secondary peritonitis. This single-test marker improves stratification of patients who will develop clinically relevant complications.
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Authors | Bettina M Rau, Isabella Frigerio, Markus W Büchler, Karl Wegscheider, Claudio Bassi, Pauli A Puolakkainen, Hans G Beger, Martin K Schilling |
Journal | Archives of surgery (Chicago, Ill. : 1960)
(Arch Surg)
Vol. 142
Issue 2
Pg. 134-42
(Feb 2007)
ISSN: 0004-0010 [Print] United States |
PMID | 17309964
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- CALCA protein, human
- Glycoproteins
- Protein Precursors
- Calcitonin
- C-Reactive Protein
- Calcitonin Gene-Related Peptide
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Topics |
- Adult
- Aged
- C-Reactive Protein
(metabolism)
- Calcitonin
(blood)
- Calcitonin Gene-Related Peptide
- Female
- Follow-Up Studies
- Glycoproteins
(blood)
- Humans
- Luminescent Measurements
- Male
- Middle Aged
- Peritonitis
(blood, complications)
- Prognosis
- Prospective Studies
- Protein Precursors
(blood)
- ROC Curve
- Risk Factors
- Severity of Illness Index
- Shock, Septic
(blood, etiology)
- Time Factors
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