Serum Procalcitonin Levels in Postoperative Monitoring of Diabetic Patients with Posterior Lumber Vertebral Stabilization Surgery: A Prospective Comparative Study

Abstract

Objective: To compare the serum procalcitonin levels and other infection markers released in response to the inflammatory response that develops secondary to the operation in patients with or without type 2 diabetes mellitus who underwent spinal instrumentation. Methods: Fifty patients, who belonged to the American Society of Anesthesiologist I-II, were between 18 and 65 years of age, and who had planned for posterior spinal instrumentation surgery were grouped into 2 as group I (n = 25) type 2 diabetic patients (group DM) and group II (n = 25) non-diabetic patients (group non-DM). On the operation day, preoperatively ( T 0 ), 5 minutes after intraoperative instrument placement (T 1 ), on postoperative 24th hour (T 2 ), 48th hour (T 3 ), 3rd day (T 4 ), 5th day (T 5 ), 7th day (T 6 ), 10th day (T 7 ), and 15th day (T 8 ), serum samples were obtained from the patients for the evaluation of procalcitonin, C-reactive protein, erythrocyte sedimentation rate, and neutrophil values. Results: Procalcitonin levels were higher in the diabetic patient group at all time points ( P < .01); C-reactive protein levels were higher in T 1 , T 2 , and T 5 in the diabetic patient group ( P < .05). There was no difference in erythrocyte sedimentation rate or neutrophil counts between the groups ( P > .05). When the alterations in procalcitonin levels were compared between diabetic and non-diabetic groups, in diabetic patients, there were significantly higher increases in the first 6 timelines ( P < .05). Conclusion: In diabetic patients, the procalcitonin levels were significantly higher at all time points, predicting an augmented bacterial infection in those patients compared with the non-diabetic patients.