OBJECTIVE: The purpose of our study was to describe perioperative kinetics of procalcitonin (PCT) in patients undergoing aortic surgery, to compare the kinetics in the open abdominal aortic aneurysm (AAA) repair and aortobifemoral bypass for aortoiliac occlusive disease (AIOD), and to evaluate the ability of PCT to detect intestinal ischaemia. METHODS: A prospective non-randomized observational cohort study in 80 patients (62 men and 18 women) undergoing elective aortic surgery was performed. Serum PCT was measured at baseline and defined intraoperative and postoperative timepoints up to postoperative day 7. MRI contrast-enhanced imaging was used to detect intestinal ischaemia. RESULTS: The comparison of the AAA and AIOD cohort did not show any significant difference in PCT levels. Patients with intestinal ischaemia had higher serum PCT at multiple timepoints postoperatively. The most accurate timepoints for early diagnosis were postoperative day 3, followed by 24 h after declamping of the vascular reconstruction, and postoperative day 7. The sensitivity and negative predictive values were 100% in all mentioned timepoints. However, event at the best timepoint the specificity was 89% and the positive predictive value 43%. CONCLUSIONS: Procalcitonin levels in the postoperative period at proper timepoints might help to detect postoperative intestinal ischaemia. The limitation of this marker is its low specificity for intestinal ischaemia and low positive predictive value. The highest value of this marker is that it can rule out this complication because normal PCT levels mean that intestinal ischaemia is very unlikely.

1st Department of Internal Medicine Faculty of Medicine Comenius University and University Hospital Bratislava Slovakia

2nd Department of Surgery Faculty of Medicine Masaryk University Brno Czech Republic

2nd Department of Surgery St Anne's University Hospital Brno Czech Republic

Center for Translational Research and Systems Medicine Victor Babes University of Medicine and Pharmacy Timisoara Romania

Central European Institute of Technology Masaryk University Brno Czech Republic

Department of Biochemistry Faculty of Medicine Masaryk University Brno Czech Republic

Department of Biology Faculty of Medicine Masaryk University Brno Czech Republic

Department of Functional Sciences Discipline of Pathophysiology Victor Babes University of Medicine and Pharmacy Timisoara Romania

Department of Medical Imaging Faculty of Medicine Masaryk University Brno Czech Republic

Department of Medical Imaging St Anne's University Hospital Brno Czech Republic

Faculty of Health Sciences University of Ss Cyril and Methodius in Trnava Trnava Slovakia

Faculty of Medicine University of Oviedo and Central University Hospital of Asturias Oviedo Spain

Citace poskytuje Crossref.org