Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients.
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Date
2015-04
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Abstract
Background: Identifying infections early, commencing appropriate empiric antibiotic not only helps gain
control early, but also reduces mortality and morbidity. Conventional cultures take about 5 days to identify
infections. To identify the infections early biomarker like serum procalcitonin (SPC). Aims: We studied the
correlation of an elevated level of SPC and positive culture in elective adult patients undergoing cardiac
surgery. Methods: This prospective study was conducted from January to December 2013. SPC was
checked in patients showing evidence of sepsis. Simultaneously, relevant culture was also undertaken.
Correlation, specificity, and sensitivity of elevated SPC were checked. Results: A total of 819 adult patients
were included in the study. 43 of them had signs of infection and SPC levels were checked. Based on the
level of SPC criteria, 10 patients were diagnosed as “nil”, out of them, 4 had culture‑positive infections, 17
were suggested to have “mild infection,” 3 out those had culture positivity. None among the eleven patients
suggested to have “moderate infection,” had a positive culture, and one among the five suggested to have
a severe infection had a positive culture. The sensitivity was 50% and the specificity 17%. The positive
predictive value was 12% and the negative predictive value 60%. Conclusions: We failed to elicit positive
correlation between elevated SPC levels and postoperative infection in cardio surgical patients.
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Keywords
Cardiac surgery, hospital‑acquired infection, infection, procalcitonin, sepsis
Citation
Chakravarthy Murali, Kavaraganahalli Deepak, Pargaonkar Sumant, Hosur Rajathadri, Harivelam Chidananda, Bharadwaj Ashwin, Raghunathan Aditi. Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients. Annals of Cardiac Anaesthesia. 2015 Apr; 18(2): 210-214.