The relationship between serum procalcitonin and postoperative infectious complications following gastric surgery / 中华普通外科杂志

ABSTRACT

Objective To analyse the factors that have effects on patients' procalcitonin (PCT)level after gastic surgery and to evaluate PCT as a parameter for detection of infectious complications.Methods A total of 153 patients undergoing gastric surgery were included in the study between Jul 2011 and Jan 2013.Temperature and routine blood samples for determining PCT level,neutrophil ratio,white blood cell count were obtained on postoperative days (POD) 1,3,7.Predictive values for each of the markers were examined.Results Postoperative complication,preoperative infection and surgery type affected the PCT level of patients on POD 1.Meanwhile,the independent factor that had influence on PCT level on POD 3 and 7 was postoperative complication.After excluding those patients with preoperative infection,patients with infectious complication exhibited significantly higher PCT levels (t =2.92,P ＜0.01,t =5.34,P ＜0.01,t =4.03,P ＜0.05) on POD 1,3,7 respectively),neutrophil ratio (on POD 3 and 7) and WBC count (on POD 3) than did those without complication.According to receiver operating characteristic analysis,PCT showed the highest AUC on POD 1,7 (AUC =0.89 and 0.87 respectively).In the patients without complication,the mean PCT value was (0.47 ± 0.97),(0.36 ± 0.50),(0.23 ± 0.24) ng/ml on POD 1,3,7 respectively.The PCT level declined 55％ from POD 1 to POD 3 and from POD 3 to POD 7.Conclusions The serum PCT level of patients without any complication showed a decreasing trend while PCT level of those with infectious complications increased significantly.Continuous monitoring PCT level could serve as a diagnostic tool for the early identification of infectious complication after gastric surgery.