title: The prognostic value of pro-calcitonin, CRP and thyroid hormones in secondary peritonitis: a single-center prospective study.
abstract: BACKGROUND
  Infections and sepsis remain the leading cause of morbidity and mortality in secondary peritonitis. Clinicians are still challenged with the task of finding an early and reliable diagnosis of septic complications. The role of inflammatory markers (Procalcitonin (PCT), C-reactive Protein (CRP) and thyroid hormones in determining the severity of secondary peritonitis was evaluated in this study.
  
  
  METHODS
  On the preoperative and first, third, fifth, seventh, and fourteenth postoperative days, PCT, CRP, and thyroid hormone concentrations were measured in serum taken from eighty-four consecutive patients who were operated on for secondary peritonitis between January 2008 and January 2010. All data was entered and analyzed using the Statistical Package for Social Sciences, version 15.0 and clinical parameters were compared using the student's t-test.
  
  
  RESULTS
  For the groups diagnosed with perforated viscus, PCT concentrations were significantly low in contrast to high thyroid hormone levels in patients who developed postoperative complications or died when compared to patients whose postoperative course was uneventful or discharged. The PCT concentration significantly correlated with the CRP concentration and WBC count.
  
  
  CONCLUSIONS
  In the absence of postoperative complications, PCT is a better predictor of outcome than CRP in secondary peritonitis. Our study showed that a low thyroid hormone level can serve as an important prognostic parameter of disease severity in secondary peritonitis.
authors.affiliation: Department of General Surgery, Dr. Yaşar Eryılmaz Doğubeyazıt State Hospital, Ağrı, Turkey.
authors.forename: Idris
authors.initials: I
authors.lastname: Akcay
authors.affiliation: Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Alexis K
authors.initials: AK
authors.lastname: Okoh
authors.affiliation: Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Orcun
authors.initials: O
authors.lastname: Yalav
authors.affiliation: Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ismail C
authors.initials: IC
authors.lastname: Eray
authors.affiliation: Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Rencuzogullari
authors.affiliation: Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Kubilay
authors.initials: K
authors.lastname: Dalci
authors.affiliation: Department of General Surgery, Balıklıgöl State Hospital, Şanlıurfa, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Elkan
authors.affiliation: Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ali H
authors.initials: AH
authors.lastname: Alparslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D013963:Thyroid Hormones / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D013963:Thyroid Hormones; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide