Is Endocan a Diagnostic Marker for Pneumonia After Cardiac Surgery? The ENDOLUNG Study
| Autor: | Fiona Ecarnot, Guillaume Flicoteaux, Philippe Lassalle, Sidney Chocron, Karine Bardonnet, Camille Chenevier-Gobeaux, Benoit Barrucand, Andrea Perrotti |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty 030204 cardiovascular system & hematology Procalcitonin law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine law medicine Cardiopulmonary bypass Humans Prospective Studies Cardiac Surgical Procedures Prospective cohort study Aged business.industry 030208 emergency & critical care medicine Pneumonia Middle Aged medicine.disease Neoplasm Proteins Cardiac surgery Surgery Clinical trial ROC Curve Elective Surgical Procedures Anesthesia Biomarker (medicine) Female Proteoglycans Cardiology and Cardiovascular Medicine business Body mass index Biomarkers Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 105:535-541 |
| ISSN: | 0003-4975 |
| Popis: | Background Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. Methods Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery). Procalcitonin and C-reactive protein were measured at 24 and 72 hours. The preoperative and postoperative characteristics of the patients were recorded. Independent predictors of postoperative pneumonia were identified by logistic regression. Threshold values of endocan predictive of postoperative pneumonia were determined using receiver-operating characteristics curve analysis. Results Seventeen patients (11%) had pneumonia after surgery. Endocan greater than 3.7 ng/mL before induction of anesthesia, or greater than 12.1 ng/mL at 6 hours after surgery, as well body mass index higher than 27 kg/m2 and duration of surgery were independent predictors of postoperative pneumonia. At induction of anesthesia, an endocan cutoff value of 3.7 ng/mL had 65% sensitivity and 72% specificity for the prediction of postoperative pneumonia; whereas at 6 hours, with a cutoff value of 12.1 ng/mL, these values were 71% and 75%, respectively. The time saved by endocan dosage compared with clinical diagnosis of postoperative pneumonia was 96 hours. Conclusions This study shows that endocan is an early marker of postoperative pneumonia in patients after cardiac surgery. |
| Databáze: | OpenAIRE |
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