title: [Prospective study of procalcitonin as a diagnostic marker of the severity of secondary peritonitis].
abstract: BACKGROUND
  It 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.
  
  
  METHODS
  Prospective study of 57 patients operated on between December 2006-August 2008 for secondary peritonitis and classified into three 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).
  
  
  RESULTS
  PCT-Q was normal (<0.5ng/ml) in 19 patients in group A, in 2 patients in group B and none in group C (p<0.001). PCT-Q between 2-10ng/ml were found in one patient in group A, 13 in group B and none in group C (p<0.001). PCT-Q >10ng/ml were found in 10 cases in group C, 6 in group B and none in group A (p<0.001). 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<0.001) in 4 cases. Seven patients died, all of them with a PCT-Q >10mg/ml (p<0.001).
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital General de Igualada, Igualada, Barcelona, España. xvinas@csa.cat
authors.forename: Xavier
authors.initials: X
authors.lastname: Viñas Trullen
authors.forename: Rafael
authors.initials: R
authors.lastname: Rodríguez López
authors.forename: Susana
authors.initials: S
authors.lastname: Porta Pi
authors.forename: David
authors.initials: D
authors.lastname: Salazar Terceros
authors.forename: Enrique
authors.initials: E
authors.lastname: Macarulla Sanz
authors.forename: Pedro
authors.initials: P
authors.lastname: Besora Canal
authors.forename: Felix
authors.initials: F
authors.lastname: Alvarez Tellez
authors.forename: Concepción
authors.initials: C
authors.lastname: Iglesias Castro
authors.forename: Xavier
authors.initials: X
authors.lastname: Feliu Palá
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood* / Q000175:diagnosis*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide