- Procalcitonin (PCT) may help detect and rule out intra-abdominal infection (IAI) after colorectal surgery.
- Authors suggest that PCT
Why this matters
- Early diagnosis of IAI can be difficult.
- An IAI biomarker could improve outcomes and boost Enhanced Recovery After Surgery (ERAS).
- PCT is more infection-specific than C-reactive protein.
- It is unclear how helpful PCT is in predicting IAI after colorectal surgery.
- Systematic review, meta-analysis to May 2016, with anastomotic leakage included as an IAI subtype (8 articles; n=1629).
- Participants were adults, post-elective colorectal anastomosis, with PCT drawn between PODs 3 and 5.
- Primary outcome: PCT diagnostic performance to detect IAI.
- Funding: None disclosed.
- Variable bias risks.
- Pooled performance for POD 5:
- Sensitivity: 0.78 (95% CI, 0.65-0.89);
- Specificity: 0.88 (0.85-0.90);
- Diagnostic OR: 32.39 (15.01-69.88);
- Area under receiver operating curve: 0.94;
- Derived PCT cutoff value: 1.26 ng/mL on POD 5;
- Nonsignificant heterogeneity.
- Lesser performance before POD 5.
- Cutoff value requires validation.
- Unknown whether cutoff applies to laparoscopic patients.
- ERAS protocols may aim for discharge before POD 5.