Usefulness of procalcitonin in the early detection of infection after thoracic surgery.
Fiche publication
Date publication
juin 2005
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel
Tous les auteurs :
Falcoz PE, Laluc F, Toubin MM, Puyraveau M, Clement F, Mercier M, Chocron S, Etievent JP
Lien Pubmed
Résumé
OBJECTIVE: The twofold aim of this prospective clinical study was to assess the accuracy of procalcitonin as a marker of postoperative infection after thoracic surgery and to compare it with C-reactive protein. METHODS: Procalcitonin and C-reactive protein concentrations, clinical symptoms of infection and systemic inflammation were recorded preoperatively and 5 days postoperatively in 157 patients undergoing the following procedures: 52 wedge resections, 28 pneumonectomies and 77 lobectomies (or bilobectomies). Patients were classified as non-infected or infected according to predefined criteria. RESULTS: In non-infected patients (n=132), procalcitonin peaked on day 1 and C-reactive protein, on day 2. The procalcitonin value was significantly higher in patients having undergone a pneumonectomy (0.73+/-0.78 versus 0.54+/-0.25 ng/mL for lobectomy and 0.50+/-0.35 ng/mL for wedge resection; P=0.04). The mean value of procalcitonin was significantly higher in patients with postoperative infection (n=25) than in those with no postoperative infection (3.6+/-5.5 versus 0.63+/-0.62 ng/mL; P=0.0001). The onset of infection most frequently occurred on postoperative day 2 (43% of patients); maximum procalcitonin and C-reactive protein concentrations most frequently appeared on postoperative day 1 (56% of patients) and day 2 (63% of patients), respectively. The best cutoff value for detection of infection with procalcitonin was 1 ng/mL and with C-reactive protein, 100mg/L. Comparing the area under the Receiver Operating Characteristic curves, procalcitonin was better than C-reactive protein for detecting postoperative infection (0.92 versus 0.66; P
Référence
Eur J Cardiothorac Surg. 2005 Jun;27(6):1074-8