Prospective study of procalcitonin as a diagnostic marker of the severity of secondary peritonitis

Abstract

IntroductionIt has been shown that procalcitonin (PCT) is a good marker for sepsis as the more severe the infection the higher the plasma levels. The Mannheim peritonitis index (MPI) is very effective in assessing the prognosis of secondary peritonitis. The aim of this study is to find out whether there is any correlation between preoperative PCT levels and the postoperative MPI, as well as the prognostic value of preoperative PCT levels. Patients and methodProspective study of 57 patients operated on between December 2006–August 2008 for secondary peritonitis and classified into 3 groups (A: 23 patients, B: 24 patients, and C: 10 patients) from lowest to highest severity of MPI. The preoperative values of procalcitonin were obtained with PCT-Q test (BRAHMS). ResultsPCT-Q was normal (<0.5ng/mL) in 19 patients in group A, in 2 patients in group B, and none in group C (P<.001). PCT-Q between 2–10ng/mL were found in 1 patient in group A, 13 in group B, and none in group C (P<.001). PCT-Q>10ng/mL were found in 10 cases in group C, 6 in group B, and none in group A (P<.001). Of the 19 patients admitted to the intensive care unit, the PCT-Q was >10ng/mL in 15 cases vs a PCT-Q<10mg/mL (P<.001) in 4 cases. Seven patients died, all of them with a PCT-Q>10mg/mL (P<.001). ConclusionsThe correlation between preoperative PCT-Q and postoperative MPI is positive and significant. The values of PCT-Q are higher as the MPI severity increases. Values >10ng/mL are significant for admission to the ICU and a poor clinical prognosis.