ABSTRACT
Introducción Se ha demostrado que la procalcitonina (PCT) es un buen marcador de sepsis, ya que sus concentraciones en plasma aumentan cuanto más grave es la infección. El índice de Mannheim (MPI) es muy eficaz para evaluar el pronóstico de la peritonitis secundaria. El objetivo de este estudio es analizar si hay correlación entre las concentraciones de PCT preoperatorias y el MPI postoperatorio, así como el valor pronóstico de las cifras preoperatorias de PCT. Pacientes y método Estudio prospectivo sobre un total de 57 pacientes intervenidos entre diciembre de 2006 y agosto de 2008 por peritonitis secundaria y clasificados en 3 grupos (A: 23 pacientes, B: 24 pacientes y C: 10 pacientes) de menor a mayor gravedad del MPI. Los valores de procalcitonina preoperatoria se obtuvieron con el PCT-Q test (BRAHMS). Resultados El PCT-Q fue normal (<0,5ng/ml) en 19 pacientes del grupo A, en 2 pacientes del grupo B y en ninguno del grupo C (p<0,001). El PCT-Q de 2 10ng/ml se objetivó en 1 paciente del grupo A, 13 del grupo B y ninguno del grupo C (p<0,001). Un PCT-Q >10ng/ml se halló en los 10 pacientes del grupo C, en 6 pacientes del grupo B y en ninguno del grupo A (p<0,001). De un total de 19 pacientes ingresados en la unidad de cuidados intensivos (UCI), en 15 casos el PCT-Q fue >10ng/ml frente a 4 casos con PCT-Q<10ng/ml (p<0,001); 7 pacientes fallecieron, en todos ellos la PCT-Q fue >10ng/ml (p<0,001).Conclusiones La correlación entre PCT-Q preoperatoria y MPI postoperatorio es positiva y significativa, los valores del PCT-Q son más elevados a mayor gravedad del MPI. Valores mayores de 10/ng/ml de PCT-Q son significativos para el ingreso en UCI y mal pronóstico del cuadro clínico (AU)
Introduction It has been shown that procalcitonin (PCT) is a good marker for sepsis as the more severe the infection the higher the plasma levels. The Mannheim peritonitis index (MPI) is very effective in assessing the prognosis of secondary peritonitis. The aim of this study is to find out whether there is any correlation between preoperative PCT levels and the postoperative MPI, as well as the prognostic value of preoperative PCT levels. Patients and method Prospective study of 57 patients operated on between December 2006 August 2008 for secondary peritonitis and classified into three groups (A: 23 patients, B: 24 patients and C: 10 patients) from lowest to highest severity of MPI. The preoperative values of procalciton in were obtained with PCT-Q test (BRAHMS). Results PCT-Q was normal (<0.5ng/ml) in 19 patients in group A, in 2 patients in group B and none in group C (p<0.001). PCT-Q between 2 10ng/ml were found in one patient in group A, 13 in group B and none in group C (p<0.001). PCT-Q >10ng/ml were found in 10 cases in group C, 6 in group B and none in group A (p<0.001). Of the 19 patients admitted to the intensive care unit, the PCT-Q was >10ng/ml in 15 cases vs a PCT-Q<10mg/ml (p<0.001) in 4 cases. Seven patients died, all of them with a PCT-Q >10mg/ml (p<0.001).Conclusions The correlation between preoperative PCT-Q and postoperative MPI is positive and significant. The values of PCT-Q are higher as the MPI severity increases. Values >10ng/ml are significant for admission to the ICU and a poor clinical prognosis (AU)
Subject(s)
Humans , Calcitonin/analysis , Peritonitis/complications , Sepsis/diagnosis , Severity of Illness Index , Prospective Studies , Biomarkers/analysis , Risk Factors , Risk Adjustment/methodsABSTRACT
INTRODUCTION: It has been shown that procalcitonin (PCT) is a good marker for sepsis as the more severe the infection the higher the plasma levels. The Mannheim peritonitis index (MPI) is very effective in assessing the prognosis of secondary peritonitis. The aim of this study is to find out whether there is any correlation between preoperative PCT levels and the postoperative MPI, as well as the prognostic value of preoperative PCT levels. PATIENTS AND METHOD: Prospective study of 57 patients operated on between December 2006-August 2008 for secondary peritonitis and classified into three groups (A: 23 patients, B: 24 patients and C: 10 patients) from lowest to highest severity of MPI. The preoperative values of procalcitonin were obtained with PCT-Q test (BRAHMS). RESULTS: PCT-Q was normal (<0.5ng/ml) in 19 patients in group A, in 2 patients in group B and none in group C (p<0.001). PCT-Q between 2-10ng/ml were found in one patient in group A, 13 in group B and none in group C (p<0.001). PCT-Q >10ng/ml were found in 10 cases in group C, 6 in group B and none in group A (p<0.001). Of the 19 patients admitted to the intensive care unit, the PCT-Q was >10ng/ml in 15 cases vs a PCT-Q<10mg/ml (p<0.001) in 4 cases. Seven patients died, all of them with a PCT-Q >10mg/ml (p<0.001). CONCLUSIONS: The correlation between preoperative PCT-Q and postoperative MPI is positive and significant. The values of PCT-Q are higher as the MPI severity increases. Values >10ng/ml are significant for admission to the ICU and a poor clinical prognosis.
