Systematic review and meta-analysis of the use of serum procalcitonin levels to predict intra-abdominal infections after colorectal surgery
| Autor: | Winson Jianhong Tan, Fung Joon Foo, Choong Leong Tang, Nurun Nisa de Souza, Wan Qi Ng, Min Hoe Chew, Wah Siew Tan, Rehena Sultana |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Calcitonin
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Anastomotic Leak 030230 surgery Sensitivity and Specificity Procalcitonin 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine parasitic diseases Odds Ratio medicine Humans Intra-Abdominal Infection business.industry Abdominal Infection Gastroenterology Hepatology bacterial infections and mycoses Colorectal surgery ROC Curve 030220 oncology & carcinogenesis Meta-analysis embryonic structures Intraabdominal Infections business Colorectal Surgery Publication Bias hormones hormone substitutes and hormone antagonists |
| Zdroj: | International Journal of Colorectal Disease. 33:171-180 |
| ISSN: | 1432-1262 0179-1958 |
| DOI: | 10.1007/s00384-017-2956-8 |
| Popis: | There has been much recent interest in the use of procalcitonin (PCT) as a marker of intra-abdominal infection (IAI) following colorectal surgery. However, the literature remains divided on the value of PCT in this setting. This meta-analysis aims to evaluate the value of PCT in predicting IAI after colorectal surgery.Systemic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews to identify studies evaluating the diagnostic accuracy of PCT as a predictor for detecting IAI on postoperative days (POD) 3 to 5 following colorectal surgery. A meta-analysis was performed using random effect model and pooled predictive parameters as well as cut-off values for POD 3 to 5 were derived.Eight studies consisting 1629 patients were included. The pooled prevalence of IAI was 5.7% on POD 3, 9.7% on POD 4, and 6.3% on POD 5. The pooled AUC for POD 3 to 5 were 0.83 (95% CI 0.78-0.88), 0.79 (95% CI 0.64-0.93), and 0.94 (95% CI 0.91-0.97), respectively. The derived PCT cut-off values were 1.45 ng/ml on POD 3, 1.28 ng/ml on POD 4, and 1.26 ng/ml on POD 5. PCT had the highest diagnostic capability on POD 5 with diagnostic odds ratio of 32.9 (95% CI 15.01-69.88), sensitivity of 0.78 (95% CI 0.65-0.89), and specificity of 0.88 (95% CI 0.85-0.90).PCT is a useful diagnostic predictor of IAI after colorectal surgery. It has the greatest diagnostic accuracy on POD 5 and can help guide safe discharge of patients after colorectal surgery. |
| Databáze: | OpenAIRE |
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