title: Serum Procalcitonin as a Valuable Diagnostic Tool in the Early Detection of Infectious Complications after Open Abdominal Aortic Repair.
abstract: BACKGROUND
  Aortic aneurysm repair is a resolutive and effective surgical operation, which can be associated with severe postoperative complications. Procalcitonin (PCT) in clinical practice could play a role in early diagnosis and monitoring of therapy for complications, especially infections, making for timely and more effective interventions. Our aim was to investigate whether PCT could be a predictive marker in early diagnosis of infectious complications after open abdominal aortic surgery.
  
  
  METHODS
  Eighty-three consecutive patients who underwent elective open aortic repair at our institution were enrolled. Blood samples were taken before surgery, and each day over the 7-day postoperative period, and measurement of serum PCT, C-reactive protein (CRP), and leukocytes levels were carried out. Data regarding clinical progress, instrumental examinations, and blood chemistry were prospectively collected.
  
  
  RESULTS
  Postoperative infectious complications occurred in 24 patients. Within 30 days, 1 death occurred. In the study sample, we found a significant difference in PCT curves of patients with and without infectious complications, especially on third postoperative day (POD; P = 0.004). On analysis of the area under the curve (AUC curve), PCT was shown to be a fair predictor in distinguishing cases with infectious complications (AUC, 0.765 on third POD; CI, 0.638-0.877). Conversely, other inflammatory markers commonly used (leucocytes and CRP) had similar trends in patients with and without postoperative infections.
  
  
  CONCLUSIONS
  On the basis of the results collected in this pilot study, despite some limitations, PCT could be considered a better marker of infectious complications after open abdominal aortic repair, when compared with other routinely used parameters.
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Varetto
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy. Electronic address: claudio.castagno83@gmail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Castagno
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Trucco
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Frola
authors.affiliation: Department of Public Health Sciences, University of Turin, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bert
authors.affiliation: Department of Public Health Sciences, University of Turin, Turin, Italy.
authors.forename: Gitana
authors.initials: G
authors.lastname: Scozzari
authors.affiliation: Division of Vascular Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Rispoli
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D042241:Early Diagnosis; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007558:Italy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012141:Respiratory Tract Infections / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D013530:Surgical Wound Infection / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality
chemical_list: D015415:Biomarkers; D002116:Calcitonin; D002097:C-Reactive Protein