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Procalcitonin is a valuable prognostic marker in cardiac surgery but not specific for infection

H Dörge1, F A Schöndube, P Dörge

  • 1Thoracic Cardiovascular Surgery, Heart Center Göttingen, Georg-August-University Göttingen, Germany. doerge@med.uni-goettingen.de

The Thoracic and Cardiovascular Surgeon
|December 12, 2003
PubMed

Insights

Elevated procalcitonin (PCT) levels post-cardiac surgery indicate higher mortality, infection, and complication risks. While PCT is a valuable prognostic marker, it cannot distinguish between infectious and non-infectious complications.

Area of Science:

  • Biomarkers in Critical Care
  • Cardiac Surgery Outcomes
  • Infectious Disease Markers

Background:

  • The prognostic significance of procalcitonin (PCT) in early post-cardiac surgery patients on cardiopulmonary bypass (CPB) is not well-established.
  • Investigating PCT's utility as a prognostic marker for mortality, complications, and infections after cardiac surgery is crucial.

Purpose of the Study:

  • To evaluate the prognostic value of serum procalcitonin (PCT) levels in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
  • To determine if PCT can predict mortality, severe complications, and infections, and if it specifically indicates infections.

Main Methods:

  • A prospective study of 80 high-risk patients (APACHE II-score: 25.1 ± 4.7) undergoing cardiac surgery.
  • Serum PCT levels were measured preoperatively and on postoperative day 1.
  • Demographic, operative data, and clinical outcomes (mortality, infection, severe complications) were documented.

Main Results:

  • Postoperative PCT levels were significantly higher in non-survivors, patients with severe complications, and those with infections compared to their counterparts.
  • PCT demonstrated predictive value for mortality (AUC: 0.772), infections (AUC: 0.720), and complications (AUC: 0.861).
  • Preoperative PCT levels were normal; however, PCT did not differentiate between infectious and non-infectious complications.

Conclusions:

  • Elevated postoperative procalcitonin (PCT) levels are associated with increased mortality, infections, and severe complications following cardiac surgery with CPB.
  • PCT serves as a valuable prognostic marker in this patient population.
  • PCT levels do not distinguish between infectious and non-infectious causes of complications.
Abstract

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