Role of procalcitonin in diagnosis of bacterial infection in trans-arterial chemoembolisation treated hepatocellular carcinoma patients

Dabbous, Helene; Ali-Eldin, Fatma A.; Montasser, Iman M.F.

doi:10.1016/j.ajg.2015.03.001

Cited by 5 publications

(7 citation statements)

References 28 publications

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“…However, a considerable number of patients experience the postembolization or postablation syndrome, which is a transient self-limiting complex of symptoms or signs of fever and general malaise [ 4 , 22 ]. In our study, fever after TACE and/or RFA was observed in 17.2% of patients, which is comparable to another study [ 13 ]. Even though the actual incidence of bacterial infection in patients undergoing TACE and/or RFA is quite low (0.8–2.5%) [ 4 , 13 ], fever always causes a concern for infectious complications frequently leading physicians to prescribe unnecessary antibiotics.…”

Section: Discussionsupporting

confidence: 91%

“…In our study, fever after TACE and/or RFA was observed in 17.2% of patients, which is comparable to another study [ 13 ]. Even though the actual incidence of bacterial infection in patients undergoing TACE and/or RFA is quite low (0.8–2.5%) [ 4 , 13 ], fever always causes a concern for infectious complications frequently leading physicians to prescribe unnecessary antibiotics.…”

Section: Discussionsupporting

confidence: 91%

“…In patients with decompensated liver cirrhosis, PCT showed the best diagnostic value relative to C-reactive protein (CRP), interleukin-6, and tumor necrosis factor- α [ 12 ]. Dabbous et al reported the clinical usefulness of PCT for diagnosing bacterial infection in postembolization syndrome [ 13 ]. However, their study was performed in a relatively small number of patients, and the clinical application of PCT on the decision to start antibiotic treatment has never been validated.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma

Kang

Kim

et al. 2018

Disease Markers

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This prospective observational study aimed at investigating the role of procalcitonin (PCT) in diagnosing bacterial infection and guiding antibiotic therapy for hepatocellular carcinoma (HCC) patients with fever after transarterial chemoembolization (TACE) and/or radiofrequency ablation (RFA). Ninety-seven cases (84 patients) were enrolled. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) counts were measured on the day of fever onset (day 0) and days 1, 3, 5, and 7 of fever. Empirical antibiotics were initiated only if PCT was ≥0.5 ng/mL or specific infection foci were suspected. An infectious cause was found in nine cases. PCT on day 0 of fever was significantly higher in patients with bacterial infection than in those without infection (P = 0.035). The area under the receiver operating characteristic curve for PCT was 0.715 (95% confidence interval, 0.538–0.892) and was higher than that for CRP (0.598 (0.368–0.828)) or WBC counts (0.502 (0.307–0.697)). In patients undergoing TACE and/or RFA, a significantly lower number of antibiotics were prescribed during the study period than during the prestudy period (P < 0.001). In conclusion, PCT might be a biomarker for diagnosing infection and guiding antibiotic treatment to reduce unnecessary antibiotic use in patients with fever after TACE and/or RFA.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma

Kang

Kim

et al. 2018

Disease Markers

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“…Dabbous et al [32] reported PCT was a promising marker for diagnosis of sepsis in HCC patients treated by TACE and PCT levels were significant correlated with positive bacterial cultures and post interventional CRP. The early detection of bacterial infections and HCC could ameliorate the prognosis of cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of serum procalcitonin in patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization

et al. 2017

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Although procalcitonin (PCT) is a valid marker for early diagnosis of bacterial infections, its accuracy in hepatocellular carcinoma (HCC) patients is unknown. The aim of this study was to investigate the prognostic significance of PCT in patients with unresectable HCC treated with transcatheter arterial chemoembolization (TACE).A total of 509 patients with unresectable HCC initially treated with TACE were enrolled in this retrospective study. According to quartile of the PCT values, all patients were divided into 4 groups. Overall survival (OS) was evaluated with the Kaplan–Meier method. Significant difference was estimated with the Log rank method. Univariate and multivariate analyses were used for evaluating the significance of the prognostic factor.The median follow-up period was 18 months and there were significant differences in the survival rates between the 4 groups. The HR (95% CI) for all-cause mortality comparing patients with PCT Quartile2–4 to patient with Quartile1 (HR = 1.00) were 1.353 (1.023–1.791), 1.799 (1.354–2.390), 1.960 (1.455–2.639), respectively, (P < .001). PCT level was an important prognostic factor for predicting the prognosis of patients with unresectable HCC treated with TACE.

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“…Considering the rising levels of serum procalcitonin in those associated diseases, the measurement of procalcitonin can be used as a diagnostic or prognostic marker of diseases [21,22]. In present study, we performed a retrospective cohort study of 115 critically ill patients with ventilator-associated pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Serum Procalcitonin Level and Mortality Risk in Critically ill Patients with Ventilator-Associated Pneumonia

Li¹,

Zhao

Li³

2015

Cell Physiol Biochem

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Background/Aims: The prognostic role of serum procalcitonin level in critically ill patients with ventilator-associated pneumonia was unclear. The aim of our study was to investigate the relationship between serum procalcitonin level and mortality risk in critically ill patients with ventilator-associated pneumonia. Methods: Data of critically ill patients with ventilator-associated pneumonia were retrospectively collected. Demographics, comorbidities, and serum procalcitonin level were extracted from electronic medical records. The primary outcome was mortality within two months after diagnosis. Multivariable Cox regression analyses were performed to assess the prognostic role of serum procalcitonin level in those patients. Results: A total of 115 critically ill patients with ventilator-associated pneumonia were enrolled in our study. Serum procalcitonin level was not associated with age, gender, or other comorbidities. Univariate Cox regression model showed that high serum procalcitonin level was associated increased risk of morality within 2 months after diagnosis (OR = 2.32, 95% CI 1.25-4.31, P = 0.008). Multivariable Cox regression model showed that high serum procalcitonin level was independently associated increased risk of morality within 2 months after diagnosis (OR = 2.38, 95% CI 1.26-4.50, P = 0.008). Conclusion: High serum procalcitonin level is an independent prognostic biomarker of mortality risk in critically ill patients with ventilator-associated pneumonia, and it's a promising biomarker of prognosis in critically ill patients.

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Role of procalcitonin in diagnosis of bacterial infection in trans-arterial chemoembolisation treated hepatocellular carcinoma patients

Cited by 5 publications

References 28 publications

Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma

Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma

Prognostic significance of serum procalcitonin in patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization

Serum Procalcitonin Level and Mortality Risk in Critically ill Patients with Ventilator-Associated Pneumonia

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