Procalcitonin kinetics following abdominal aortic surgery and its value for postoperative intestinal ischaemia detection.

Autor:	Novotny T; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Staffa R; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Tomandl J; Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Krivka T; Department of Medical Imaging, St. Anne's University Hospital Brno, Czech Republic.; Department of Medical Imaging, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Kruzliak P; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Tomandlova M; Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Slaby O; Central European Institute of Technology, Masaryk University, Brno, Czech Republic.; Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Sponiar J; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Caprnda M; 1st Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia., Gaspar L; Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia., Rodrigo L; Faculty of Medicine, University of Oviedo and Central University Hospital of Asturias (HUCA), Oviedo, Spain., Mozos I; Department of Functional Sciences, Discipline of Pathophysiology, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania.; Center for Translational Research and Systems Medicine, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania., Kubicek L; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Biros E; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Vlachovsky R; 2nd Department of Surgery, St. Anne's University Hospital Brno, Czech Republic.; 2nd Department of Surgery, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Radova L; Central European Institute of Technology, Masaryk University, Brno, Czech Republic., Konieczna A; Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
Jazyk:	angličtina
Zdroj:	Vascular [Vascular] 2023 Dec; Vol. 31 (6), pp. 1061-1068. Date of Electronic Publication: 2022 May 20.
DOI:	10.1177/17085381221102812
Abstrakt:	Objective: The purpose of our study was to describe perioperative kinetics of procalcitonin (PCT) in patients undergoing aortic surgery, to compare the kinetics in the open abdominal aortic aneurysm (AAA) repair and aortobifemoral bypass for aortoiliac occlusive disease (AIOD), and to evaluate the ability of PCT to detect intestinal ischaemia. Methods: A prospective non-randomized observational cohort study in 80 patients (62 men and 18 women) undergoing elective aortic surgery was performed. Serum PCT was measured at baseline and defined intraoperative and postoperative timepoints up to postoperative day 7. MRI contrast-enhanced imaging was used to detect intestinal ischaemia. Results: The comparison of the AAA and AIOD cohort did not show any significant difference in PCT levels. Patients with intestinal ischaemia had higher serum PCT at multiple timepoints postoperatively. The most accurate timepoints for early diagnosis were postoperative day 3, followed by 24 h after declamping of the vascular reconstruction, and postoperative day 7. The sensitivity and negative predictive values were 100% in all mentioned timepoints. However, event at the best timepoint the specificity was 89% and the positive predictive value 43%. Conclusions: Procalcitonin levels in the postoperative period at proper timepoints might help to detect postoperative intestinal ischaemia. The limitation of this marker is its low specificity for intestinal ischaemia and low positive predictive value. The highest value of this marker is that it can rule out this complication because normal PCT levels mean that intestinal ischaemia is very unlikely. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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