Procalcitonin predicts IAI after colorectal surgery
Procalcitonin (PCT) levels are an accurate diagnostic predictor of intra-abdominal infection (IAI) following colorectal surgery, according to a recent study.
The researchers performed a meta-analysis of eight studies, corresponding to 1,629 patients, that evaluated the diagnostic value of PCT for IAI in postoperative days 3–5 in patients who underwent colorectal surgery.
Pooled data from all eight studies showed an IAI prevalence of 5.7 percent 3 days after surgery. This rose to 9.7 percent on day 4 and dropped to 6.3 percent on day 5. On day 3, PCT showed a diagnostic odds ratio (DOR) of 13.92 (95 percent CI, 5.70–34.00) and an area under the curve (AUC) of 0.83. The corresponding sensitivity and specificity at this time point was 0.68 and 0.85.
Three studies were pooled to evaluate the performance of PCT on day 4. The analysis resulted in a sensitivity of 0.81 and specificity of 0.52. The DOR and AUC values were 5.08 (1.88–13.76) and 0.79, respectively.
PCT had the highest diagnostic value for IAI 5 days after the operation, which was evaluated in three studies. The pooled analysis revealed a sensitivity and specificity of 0.78 and 0.88 percent, respectively. The DOR was at its highest value of 32.39 (15.01–69.88), while the AUC was calculated to be 0.94.
In terms of overall quality, measured using the revised Quality Assessment of Diagnostic Accuracy Studies, some studies had poorly defined criteria of the reference tests used. The applicability of two studies was also questionable because of considerable patient attrition and exclusion of emergency cases.