The diagnostic value of determining the level of procalcitonin in abdominal surgery

Abstract

Successful treatment of peritonitis due to perforation of the gastrointestinal tract remains a challenge even in the era of modern surgery. The incidence of infectious and non-infectious complications remains high, as does mortality. Rapid diagnosis, effective surgery, and assessment of the adequacy of the sanitization of the infectious focus are the most important cornerstones of any treatment algorithm. The purpose of the study was to analyze the significance of procalcitonin in the diagnosis of complicated secondary peritonitis. Materials and methods . The article presents the data of the study of 51 patients with intraoperative diagnosis of secondary peritonitis as a complication of perforation of the abdominal cavity of inflammatory nature. The level of procalcitonin was evaluated intraoperatively, as well as on 1, 2, 3 days of the patient's stay in the hospital. Depending on the outcome of the disease, the patients were divided into 2 groups. All patients initially showed an increase in the level of procalcitonin more than 0,5 ng/ml. In 54,9% of the subjects, the level of procalcitonin exceeded 10 ng/ml. The median PCT concentration on the first day was 10,7 (0,87; 190,4). Results . As a result of the study it was found: 1. In the case of adequate sanitation of the infectious focus in the abdominal cavity, a significant decrease in the level of procalcitonin in the blood was recorded, already in the first day of observation. 2. In patients, the level of procalcitonin which in the dynamics of 1, 2 days remained at the level of the original or there was an increase, testified to the continuation of the infectious and inflammatory process and required repeated relaparotomies and additional sanations. In all cases of unfavorable course of the disease, high rates of procalcitonin test were recorded, which can be considered as an unfavorable prognostic sign.