Role of serum procalcitonin in predicting the surgical outcomes of acute calculous cholecystitis
Autor: | Pietro Fransvea, Marcello Covino, Gabriele Sganga, Francesco Franceschi, Sergio Alfieri, Giuseppe Quero, Caterina Puccioni, Antonio La Greca, Fausto Rosa, Valerio Cozza |
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Rok vydání: | 2021 |
Předmět: |
Laparoscopic surgery
medicine.medical_specialty Settore MED/18 - CHIRURGIA GENERALE medicine.medical_treatment Cholecystitis Acute Procalcitonin Internal medicine Cholecystitis medicine Humans Retrospective Studies business.industry Surgical outcomes Emergency department Middle Aged Vascular surgery medicine.disease Acute cholecystitis Cardiac surgery Treatment Outcome Cholecystectomy Laparoscopic Cardiothoracic surgery Surgery business Abdominal surgery |
Zdroj: | Langenbeck's Archives of Surgery. 406:2375-2382 |
ISSN: | 1435-2451 1435-2443 |
Popis: | Acute calculous cholecystitis (AC) is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. In the preoperative planning, the severity of AC should be considered as well as time of onset of symptoms and patient comorbidities. The aim of the present study was to investigate the role of an early PCT assessment in the emergency department in predicting the outcomes of laparoscopic surgery for AC. Retrospective, mono-centric study conducted in a teaching urban hospital. We evaluated all patients admitted to our ED from January 1st, 2015, to December 31st, 2019, underwent laparoscopic cholecystectomy for AC having a preoperative PCT determination in ED. A total of 2285 patients in our ED were admitted for AC. Among them 822 patients were treated surgically, 174 had a PCT determination in ED. Median age was 63 [50–74]. Overall, 33 patients (19.0%) had major complications (MC): 32 needed an open surgery conversion, and 3 among them deceased. Multivariate analysis demonstrated that PCT, WBC, BUN, and CCI were significantly associated to MC in our cohort. When we calculated the area under the ROC curve with regard to MC, a procalcitonin value > 0.09 at admission had sensitivity = 84.8% [68.1–94.9] and specificity = 51.8% [43.2–60.3] for the occurrence of MC. Our results, suggest that a PCT > 0.09 ng/mL at ED admission, could be associated to a poor surgical outcome in patients treated by laparoscopic surgery for AC. |
Databáze: | OpenAIRE |
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