title: Procalcitonin in the recognition of complications in critically ill surgical patients.
abstract: BACKGROUND
  Procalcitonin (PCT) is a relatively new, promising indirect parameter for infection. In the intensive care unit (ICU) it can be used as a marker for sepsis. However, in the ICU there is a need for reliable markers for clinical deterioration in the critically ill patients. This study determines the clinical value of PCT concentrations in recognizing surgical complications in a heterogeneous group of general surgical patients in the ICU.
  
  
  METHODS
  We prospectively collected PCT concentration data from April 2010 to June 2012 for all general surgical patients admitted to the ICU. Both the relationships between PCT levels and events (diagnostic and therapeutic interventions) as well as between PCT levels and surgical complications (abscesses, bleeding, perforation, ischemia, and ileus) were studied.
  
  
  RESULTS
  PCT concentrations were lower in patients who developed complications than those who did not develop complications on the same day, although not significant (P = 0.27). A 10% increase in PCT levels resulted in a 2% higher complication odds, but again this was not significant (odds ratio [OR], 1.020; 95% confidence interval [CI], 0.961-1.083; P = 0.51). Even a 20% or 30% increase in PCT concentrations did not result in higher complication probability (OR, 1.039; 95% CI, 0.927-1.165 and OR, 1.057; 95% CI, 0.897-1.246). Furthermore, an increase in PCT levels did not show an increase or a reduction in the number of diagnostic and therapeutic interventions.
  
  
  CONCLUSIONS
  An increase in PCT levels does not help to predict surgical complications in critically ill surgical patients.
authors: Department of Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: zainna.meyer@mumc.nl.
authors: Zainna C
authors: ZC
authors: Meyer
authors: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors: Jennifer M J
authors: JM
authors: Schreinemakers
authors: Department of Epidemiology, Amphia Hospital, Breda, The Netherlands.
authors: Paul G H
authors: PG
authors: Mulder
authors: Laboratory for Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors: Lianne
authors: L
authors: Schrauwen
authors: Department of Intensive Care Medicine, Amphia Hospital, Breda, The Netherlands.
authors: Ruud A L
authors: RA
authors: de Waal
authors: Laboratory for Clinical Chemistry and Hematology, Amphia Hospital, Breda, The Netherlands.
authors: Antonius A M
authors: AA
authors: Ermens
authors: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors: Lijckle
authors: L
authors: van der Laan
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D007362:Intensive Care Units; D007511:Ischemia / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Complication(s); Intensive care unit; Procalcitonin; Sugery