Procalcitonin as preoperative marker for surgery in advanced parapneumonic empyema
| Autor: | Franco Gambazzi, Philipp Schuetz, Claudio Caviezel, Stephan Gerdes |
|---|---|
| Přispěvatelé: | University of Zurich, Gambazzi, Franco |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty 10255 Clinic for Thoracic Surgery business.industry medicine.medical_treatment 610 Medicine & health Decortication medicine.disease Open pleurectomy Procalcitonin Empyema Surgery 03 medical and health sciences Pneumonia 0302 clinical medicine 030228 respiratory system 2740 Pulmonary and Respiratory Medicine medicine Clinical endpoint Original Article 030212 general & internal medicine business Prospective cohort study Pleurectomy |
| Zdroj: | Journal of Thoracic Disease. 9:734-741 |
| ISSN: | 2077-6624 2072-1439 |
| Popis: | Background: The optimal time point for surgical management of advanced parapneumonic empyema in need of open pleurectomy and decortication remains unclear. We hypothesized that surgical outcomes will be better when procalcitonin (PCT) levels have dropped to normal ranges as evidence for resolution of the underlying pneumonia. Methods: We retrospectively analyzed outcomes of 38 patients with advanced parapneumonic empyema who underwent open decortication and pleurectomy with available preoperative PCT (pPCT) values. Patients were divided into two groups based on the pPCT cut-off of 0.25 μg/L. Total length of stay was the primary endpoint. Secondary endpoints included postoperative length of stay, surgery-related complications and death. Results: Patients with a pPCT ≥0.25 μg/L had a significantly longer total length of stay compared to patients with a pPCT level vs . 15.0 days, difference −7.4 days (95% CI: −12.8 to −2.0), P=0.009]. This was also confirmed in linear regression analysis adjusting for age, gender and comorbidities [adjusted regression coefficient for log-transformed length of stay −0.27, 95% CI: −0.02 to −0.52, P=0.037]. Results for postoperative length of stay were similar. Eight patients in the pPCT ≥0.25 μg/L group had postoperative complications with two deaths while no complications occurred in the PCT vs . 0%, P=0.004). Conclusions: These data suggest better surgical outcomes in advanced parapneumonic empyema when pneumonia has resolved with a pPCT drop of |
| Databáze: | OpenAIRE |
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