title: Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis.
abstract: BACKGROUND
  Ischemic and necrotic damages are complications of digestive diseases and require emergency management. Nevertheless, the decision to surgically manage could be delayed because of no sufficiently preoperative accurate marker of ischemia diagnosis, extension, and prognosis.
  
  
  METHODS
  The aim of this study was to assess the predictive value of serum procalcitonin (PCT) levels for diagnosing intestinal necrotic damages, their extension, and their prognosis in patients with ischemic disease including ischemic colitis and mesenteric infarction by a gray zone approach. Between January 2007 to June 2014, 128 patients with ischemic colitis and mesenteric infarction (codes K55.0 and K51.9) were operated, for whom data on PCT were available. We perform a retrospective, multicenter review of their medical records. Patients were divided into subgroups: ischemia (ID group) versus necrosis (ND group); the extension [focal (FD) vs. extended (ED)] and the vital status [deceased (D) vs. alive (A)].
  
  
  RESULTS
  PCT levels were higher in the ND (n = 94; p = 0.009); ED (n = 100; p = 0.02); and D (n = 70; p = 0.0003) groups. With a gray zone approach, the predictive thresholds were (i) for necrosis 2.473 ng/mL, (ii) for extension 3.884 ng/mL, and (iii) for mortality 7.87 ng/mL.
  
  
  CONCLUSIONS
  In our population, PCT could be used as a marker of necrosis; especially in case of extended damages and reflects the patient's prognosis.
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France.|INSERM U1088, Jules Verne University of Picardie, Amiens, France.
authors.forename: C
authors.initials: C
authors.lastname: Cosse
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France.
authors.forename: C
authors.initials: C
authors.lastname: Sabbagh
authors.affiliation: Department of Digestive Surgery, Beauvais Hospital, Beauvais, France.
authors.forename: F
authors.initials: F
authors.lastname: Browet
authors.affiliation: Department of Digestive Surgery, Beauvais Hospital, Beauvais, France.
authors.forename: F
authors.initials: F
authors.lastname: Mauvais
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France.
authors.forename: L
authors.initials: L
authors.lastname: Rebibo
authors.affiliation: Department of Anesthesiology, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France.
authors.forename: E
authors.initials: E
authors.lastname: Zogheib
authors.affiliation: Department of Pathology, Amiens North Hospital, University of Picardie, 80054, Amiens Cedex 01, France.
authors.forename: D
authors.initials: D
authors.lastname: Chatelain
authors.affiliation: INSERM U1088, Jules Verne University of Picardie, Amiens, France.|Department of Biochemistry, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France.
authors.forename: S
authors.initials: S
authors.lastname: Kamel
authors.affiliation: Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.|EA4294, Jules Verne University of Picardie, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|Department of Digestive and Oncological Surgery, CHU Nord Amiens and University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.|Clinical Research Center, Amiens University Hospital, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: J M
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D017091:Colitis, Ischemic / Q000097:blood* / Q000175:diagnosis; D003106:Colon / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000097:blood* / Q000175:diagnosis; D008875:Middle Aged; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Gray zone approach; Ischemia; Procalcitonin; Tissue damages