Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study

Xie, Man; Chen, Ya Ting; Zhang, He; Zhang, Hai Tao; Pan, Ke; Chen, Xiao Fang; Xie, Xiao Li

doi:10.1532/hsf.4297

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Therefore, we proposed whether multiple indicators could be combined to predict early sepsis and the prognosis of sepsis [17,18].Jerome et al [19] reported that PCT as a diagnostic test for infection/sepsis after major abdominal surgery had only moderate e cacy, limited sensitivity and speci city. Therefore, it is necessary to combine multiple in ammatory factors for analysis [20].Liang et al [21] retrospectively analyzed clinical data of 28 patients with bloodstream infections and sepsis admitted to ICU,and found that PCT, neutrophil to lymphocyte ratio (NLR), and APACHE II score were independent risk factors for patient death within 28 days.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and interleukin-6 in predicting prognosis of sepsis patients with cancer

lyu,

Han,

Zhang

et al. 2024

Preprint

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Objective: To evaluate the ability of infection indicators to predict the prognosis of sepsis patients with tumor. Methods: A total of 317 patients admitted to ICU from January 1, 2021 to June 30, 2021 were enrolled. Among them, 163 patients were infected during peri-operative period, and 98 patients were ultimately diagnosed with sepsis. The infection indicators were analyzed forprediction of sepsis prognosis. Results: Comparison of infection indicators between sepsis and non-sepsis patients showed that procalcitonin (PCT) and interleukin-6(IL-6) showed significant changes in sepsis patients, and PCT combined with IL-6 could significantly improve specificity of early screening for sepsis and have highest positivity predictive value for sepsis. Peak value combination of PCT and IL-6 could achieve high specificity to predict poor prognosis. Peak value combination of PCT and IL-6 for prediction specificity, positive predictive value and negative predictive value was 0.935, 0.692, and 0.682 respectively. Conclusion:Abnormal increase of PCT and IL-6 has a good early warning effect on sepsis in cancer patients, and the combination of PCT and IL-6 can improve predictive specificity and increase positive predictive ability of sepsis diagnosis. PCT combined with IL-6 shows the value in predicting the prognosis of sepsis patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Procalcitonin and interleukin-6 in predicting prognosis of sepsis patients with cancer

lyu,

Han,

Zhang

et al. 2024

Preprint

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Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis

Nicolotti,

Grossi,

Palermo

et al. 2024

Crit Care

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Background and aims Patients undergoing cardiac surgery are subject to infectious complications that adversely affect outcomes. Rapid identification is essential for adequate treatment. Procalcitonin (PCT) is a noninvasive blood test that could serve this purpose, however its validity in the cardiac surgery population is still debated. We therefore performed a systematic review and meta-analysis to estimate the accuracy of PCT for the diagnosis of postoperative bacterial infection after cardiac surgery. Methods We included studies on adult cardiac surgery patients, providing estimates of test accuracy. Search was performed on PubMed, EmBase and WebOfScience on April 12th, 2023 and rerun on September 15th, 2023, limited to the last 10 years. Study quality was assessed with the QUADAS-2 tool. The pooled measures of performance and diagnostic accuracy, and corresponding 95% Confidence Intervals (CI), were calculated using a bivariate regression model. Due to the variation in reported thresholds, we used a multiple-thresholds within a study random effects model for meta-analysis (diagmeta R-package). Results Eleven studies were included in the systematic review, and 10 (2984 patients) in the meta-analysis. All studies were single-center with observational design, five of which with retrospective data collection. Quality assessment highlighted various issues, mainly concerning lack of prespecified thresholds for the index test in all studies. Results of bivariate model analysis using multiple thresholds within a study identified the optimal threshold at 3 ng/mL, with a mean sensitivity of 0.67 (0.47–0.82), mean specificity of 0.73 (95% CI 0.65–0.79), and AUC of 0.75 (IC95% 0.29–0.95). Given its importance for practice, we also evaluated PCT’s predictive capability. We found that positive predictive value is at most close to 50%, also with a high prevalence (30%), and the negative predictive value was always > 90% when prevalence was < 20%. Conclusions These results suggest that PCT may be used to help rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL identified in this work should be confirmed with large, well-designed randomized trials that evaluate the test’s impact on health outcomes and on the use of antibiotic therapy. PROSPERO Registration number CRD42023415773. Registered 22 April 2023. Graphical abstract

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An Integrated Approach Based on Clinical Data Combined with Metabolites and Biomarkers for the Assessment of Post-Operative Complications after Cardiac Surgery

Meinarovich,

Pautova,

Zuev

et al. 2024

JCM

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Background: Early diagnosis of post-operative complications is an urgent task, allowing timely prescribing of appropriate therapy and reducing the cost of patient treatment. The purpose of this study was to determine whether an integrated approach based on clinical data, along with metabolites and biomarkers, had greater predictive value than the models built on fewer data in the early diagnosis of post-operative complications after cardiac surgery. Methods: The study included patients (n = 62) admitted for planned cardiac surgery (coronary artery bypass grafting with cardiopulmonary bypass) with (n = 26) or without (n = 36) post-operative complications. Clinical and laboratory data on the first day after surgery were analyzed. Additionally, patients’ blood samples were collected before and on the first day after surgery to determine biomarkers and metabolites. Results: Multivariate PLS-DA models, predicting the presence or absence of post-operative complications, were built using clinical data, concentrations of metabolites and biomarkers, and the entire data set (ROC-AUC = 0.80, 0.71, and 0.85, respectively). For comparison, we built univariate models using the EuroScore2 and SOFA scales, concentrations of lactate, the dynamic changes of 4-hydroxyphenyllactic acid, and the sum of three sepsis-associated metabolites (ROC-AUC = 0.54, 0.79, 0.62, 0.58, and 0.70, respectively). Conclusions: The proposed complex model using the entire dataset had the best characteristics, which confirms the expediency of searching for new predictive models based on a variety of factors.

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Diagnostic Value of Procalcitonin and Interleukin-6 on Early Postoperative Pneumonia after Adult Cardiac Surgery: A Prospective Observational Study

Cited by 3 publications

References 22 publications

Procalcitonin and interleukin-6 in predicting prognosis of sepsis patients with cancer

Procalcitonin and interleukin-6 in predicting prognosis of sepsis patients with cancer

Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis

An Integrated Approach Based on Clinical Data Combined with Metabolites and Biomarkers for the Assessment of Post-Operative Complications after Cardiac Surgery

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