RT info:eu-repo/semantics/article
T1 Procalcitonin and white blood cells, combined predictors of infection in cardiac surgery patients
A1 Heredia Rodríguez, María
A1 Bustamante Munguira, Juan
A1 Lorenzo López, Mario
A1 Gómez Sánchez, Esther
A1 Álvarez González, Francisco Javier
A1 Fierro Lorenzo, María Inmaculada
A1 Conejo Jorge, Esther
A1 Tamayo Gómez, Eduardo
K1 Procalcitonin
K1 Procalcitonina
K1 leukocytes
K1 Leucocitos
K1 Biomarkers
K1 Biomarcadores
K1 Infection
K1 Infección
AB Background: Sepsis is strongly associated with an increased risk of postoperative mortality, longer length of hospital stay, and elevated health care costs. Early clinical symptoms overlap with those of systemic inflammatory response syndrome, a response that commonly occurs after cardiac surgery with cardiopulmonary bypass. Since a combination of biomarkers has been demonstrated to improve the prediction of postoperative infection, the objective of the present study was to test whether the combination of C-reactive protein (CRP), white blood cells (WBC), and procalcitonin (PCT) is able to predict postoperative infection in a large cohort of cardiac surgery patients. Material and methods: Case-control study involving 423 patients who underwent cardiac surgery with cardiopulmonary bypass. Patients were retrospectively classified into two groups based on whether they developed severe sepsis or septic shock during the postoperative period. Blood samples for biological measurements (PCT, CRP, and WBC) were drawn on the first day in the intensive care unit, then once daily in the morning until the 10th postoperative day. Results: CRP median values were similar in both groups. WBC and PCT median values were significantly higher in patients with infection than without during the first 10 postoperative days. With elevation cutoffs ≤3 times (OR: 4.058; 95% CI: 2.206-7.463; P = 0.001) and ≥4 times (OR: 10.274, 95% CI: 3.690-28.604; P < 0.001), the median value for PCT (1.7 ng/mL) and/or WBC (13,000 cells/mm3) on the second postoperative day was significantly associated with the development of infection. Conclusions: The goal of this study was to use a large cohort of cardiac surgery patients to ensure that the results were representative of this population. The combination of PCT and WBC levels over the first three postoperative days was able to predict postoperative infection within the 30 d following cardiac surgery.
PB Elsevier
SN 0022-4804
YR 2017
FD 2017
LK http://uvadoc.uva.es/handle/10324/45510
UL http://uvadoc.uva.es/handle/10324/45510
LA eng
NO Journal of Surgical Research, 2017, vol. 212. p.187-194
NO Producción Científica
DS UVaDOC
RD 22-dic-2024