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Early Kinetics of Procalcitonin in Predicting Surgical Outcomes in Type A Aortic Dissection Patients / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 1175-1181, 2017.
Artigo em Inglês | WPRIM | ID: wpr-330646
ABSTRACT
<p><b>BACKGROUND</b>In cardiac surgery, elevation of procalcitonin (PCT) could be observed postoperatively in the absence of any evidence of infection and also seems to be a prognostic marker. PCT levels measured in patients undergoing Type A aortic dissection (TAAD) were used to determine prognostic values for complications and surgical outcomes.</p><p><b>METHODS</b>Measurements of PCT, C-reactive protein (CRP), and leukocyte count were observed in TAAD surgery patients (n = 251; average age 49.02 ± 12.83 years; 78.5% male) at presurgery (T0) and 24 h (T1), 48 h (T2), and 7 days (T3) postsurgery. PCT clearance (PCTc) on days 2 and 7 was calculated (PCTday1- PCTday2/day7)/PCTday1 × 100%. Endotracheal intubation duration, length of stay (LOS) in the Intensive Care Unit (ICU)/hospital, and complications were recorded.</p><p><b>RESULTS</b>PCT peaked 24 h postsurgery (median 2.73 ng/ml) before decreasing. Correlation existed between PCT levels at T1 and duration of cardiopulmonary bypass (P = 0.001, r = 0.278). Serum PCT concentrations were significantly higher in nonsurvivor and multiple organ dysfunction syndrome groups on all postoperative days. PCT levels at T1 correlated with length of time of ventilation support and ICU/hospital LOS. Comparing PCT values of survivors versus nonsurvivors, a PCT cutoff level of 5.86 ng/ml at T2 had high sensitivity (70.6%) and specificity (74.3%) in predicting in-hospital death. PCTc-day 2 and 7 were significantly higher in survivor compared with nonsurvivor patients (38% vs. 8%, P= 0.012, 83% vs. -39%, P< 0.001). A PCTc-day 7 cutoff point of 48.7% predicted survival with high sensitivity (77.8%) and specificity (81.8%).</p><p><b>CONCLUSIONS</b>PCT level and PCTc after TAAD surgery might serve as early prognostic markers to predict postoperative outcome. PCT measurement may help identify high-risk patients.</p>
Assuntos
Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Cirurgia Geral / Sangue / Proteína C-Reativa / Calcitonina / Cinética / Estudos Prospectivos / Sensibilidade e Especificidade / Resultado do Tratamento / Período Perioperatório / Dissecção Aórtica Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: Chinese Medical Journal Ano de publicação: 2017 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Cirurgia Geral / Sangue / Proteína C-Reativa / Calcitonina / Cinética / Estudos Prospectivos / Sensibilidade e Especificidade / Resultado do Tratamento / Período Perioperatório / Dissecção Aórtica Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: Chinese Medical Journal Ano de publicação: 2017 Tipo de documento: Artigo