The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery: advantage from daily measurement

Postsurgical infections represent an important cause of morbidity after abdominal surgery. The microbiological diagnosis is notachieved in at least 30% of culture with consequent worsening of patient outcome. In this study, procalcitonin measurement, duringthe first 3 days after abdominal surgery, has been evaluated for the early diagnosis of postsurgical infection.Ninety consecutive patients subjected to major abdominal surgery at the University Campus Bio-Medico of Rome, have beenincluded. PCT concentrations were measured by time-resolved amplified cryptate emission (TRACE) assay at admission and at thefirst, second, and third day after surgery. PCT levels were compared using the Mann–Whitney test and by ANOVA test for varianceanalysis. Receiver operating characteristic (ROC) analysis was performed to define the diagnostic ability of PCT in case ofpostsurgical infections.PCT values resulted significantly different between patients developing or not developing postsurgical infections. PCT >1.0ng/mLat first or second day after surgery and >0.5ng/mL at third day resulted diagnostic for infectious complication, whereas a value <0.5ng/mL at the fifth day after surgery was useful for early and safety discharge of patients.In conclusion, PCT daily measurement could represent a useful diagnostic tool improving health care in the postsurgical periodfollowing major abdominal surgery and should be recommended.