There has been much recent interest in the use of procalcitonin (PCT) as a marker of intra-abdominal infection (IAI) following colorectal surgery.
However, the literature remains divided on the value of PCT in this setting.
Dr Wah Siew Tan and colleagues from Singapore performed a meta-analysis to evaluate the value of PCT in predicting IAI after colorectal surgery.
The researchers performed a systemic literature search using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews.
The team identified studies evaluating the diagnostic accuracy of PCT as a predictor for detecting IAI on postoperative days 3 to 5 following colorectal surgery.
The researchers included 8 studies consisting of 1629 patients.
The pooled prevalence of IAI was 6% on postoperative day 3, 10% on postoperative day 4, and 6% on postoperative day 5.
The team noted that the pooled AUC for postoperative days 3 to 5 were 0.83, 0.79, and 0.94, respectively.
The derived PCT cut-off values were 1.45 ng/ml on postoperative day 3, 1.28 ng/ml on postoperative day 4, and 1.26 ng/ml on postoperative day 5.
The research team reported that PCT had the highest diagnostic capability on postoperative day 5 with diagnostic odds ratio of 32.9, sensitivity of 0.78, and specificity of 0.88.
Dr Tan's team concludes, "PCT is a useful diagnostic predictor of IAI after colorectal surgery."
"It has the greatest diagnostic accuracy on postoperative day 5 and can help guide safe discharge of patients after colorectal surgery."