Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.

Procalcitonina y proteína C reactiva como marcadores precoces de falla de sutura digestiva.

Wagner, Gabriela - Valsangiacomo, Pablo - Rodríguez Cantera, Gabriela - Segura, Daisy - Ruso Martínez, Luis

Resumen:

Anastomotic leakage in digestive sutures determines high morbidity and mortality, but its early diagnoses is critical and controversial. There is an important interest on finding an early detection biomarker that allows early diagnoses without clinical evidences. Many studies have shown the eficacy of Procalcitonin (PCT) and C Reactive Protein (CRP) as early detection biomarkers of anastomotic leackeage, as they were demostrated as useful intraabdominal infection predictors. This prospective observational study took place in Hospital Maciel, Department of Surgery nº 3, in a period of 14 months, and included all patients undergoing elective surgery with a digestive suture. CRP and PCT were measured preoperatively and on postoperative days (POD) 1, 2, 3, 4, 5 and patients were followed for postoperative complications with the aim to determine if they were suitable as anastomotic leackage monitoring tool in the postoperative setting. We established two groups: with and without anastomotic leackage.28 patients were included. 14,3% corresponded to the anastomotic leackage group with a mortality of 3,6%. We found a statistically significative increase of both biomarkers in the leackage group (CRP p=0,001 and PCT p=0,003) with a remarkable increase specially POD 3. The main limitation of the study is the small number of patients. There was no statistically difference in demographic characteristics between groups. According to our results, postoperative PCT and CRP determination can be use as adecuated early predictors of anastomoticleackage from the POD 2.


La falla de sutura digestiva conlleva alta morbi-mortalidad y su diagnóstico precoz es un punto crítico y controversial. Se ha considerado necesario encontrar un marcador bioquímico de valor diagnóstico en ausencia de cuadro clínico evidente.Hay creciente evidencia de la eficacia de la Procalcitonina (PCT) y Proteína C Reactiva (PCR) como marcadores precoces de falla de sutura digestiva, porque ambas han mostrado ser útiles para la predicción de infección intrabdominal.Se realizó en el Hospital Maciel/ Clínica quirúrgica “3” (perío-do: 14 meses) , un estudio observacional, prospectivo, inclu-yendo todos los pacientes intervenidos de coordinación a los que se realizó una sutura digestiva. Se realizo la medición dia-ria de PCT y PCR pre y postoperatoria por 5 días con el objeti-vo de determinar la utilidad de ambas como indicadores preco-ces de falla de sutura. Se identificaron las complicaciones y establecieron dos grupos según la aparición o no de fuga anas-tomótica, diagnosticada clínicamente y/o imagenológicamente.Se incluyeron 28 pacientes, 14,3% presentaron falla de sutura con una mortalidad de 3,6%. Se encontró un aumento significativo de ambos marcadores en el grupo de falla de sutu-ra (PCR p=0,001yPCT p=0,003) con un aumento específico en el 3er día de postoperatorio.La limitante de nuestro estudio es el bajo número de casos, en lo cual no se encontró diferencia significativa en el resto de las variables analizadas.Este estudio permite inferir que la PCR y la PCT deben consi-derarse adecuados predictores precoces de falla de sutura y de infección intra-abdominal, a partir de las 48 hs de postoperato-rio.


Detalles Bibliográficos
2019
sutura digestiva
procalcitonina
proteína C reactiva
falla de sutura
suture
calprotectin
c reactive protein
anastomotic leackage
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/40
Acceso abierto
_version_ 1815772737775337472
author Wagner, Gabriela
author2 Valsangiacomo, Pablo
Rodríguez Cantera, Gabriela
Segura, Daisy
Ruso Martínez, Luis
author2_role author
author
author
author
author_facet Wagner, Gabriela
Valsangiacomo, Pablo
Rodríguez Cantera, Gabriela
Segura, Daisy
Ruso Martínez, Luis
author_role author
collection Revista Cirugía del Uruguay
dc.creator.none.fl_str_mv Wagner, Gabriela
Valsangiacomo, Pablo
Rodríguez Cantera, Gabriela
Segura, Daisy
Ruso Martínez, Luis
dc.date.none.fl_str_mv 2019-07-15
dc.description.abstract.none.fl_txt_mv Anastomotic leakage in digestive sutures determines high morbidity and mortality, but its early diagnoses is critical and controversial. There is an important interest on finding an early detection biomarker that allows early diagnoses without clinical evidences. Many studies have shown the eficacy of Procalcitonin (PCT) and C Reactive Protein (CRP) as early detection biomarkers of anastomotic leackeage, as they were demostrated as useful intraabdominal infection predictors. This prospective observational study took place in Hospital Maciel, Department of Surgery nº 3, in a period of 14 months, and included all patients undergoing elective surgery with a digestive suture. CRP and PCT were measured preoperatively and on postoperative days (POD) 1, 2, 3, 4, 5 and patients were followed for postoperative complications with the aim to determine if they were suitable as anastomotic leackage monitoring tool in the postoperative setting. We established two groups: with and without anastomotic leackage.28 patients were included. 14,3% corresponded to the anastomotic leackage group with a mortality of 3,6%. We found a statistically significative increase of both biomarkers in the leackage group (CRP p=0,001 and PCT p=0,003) with a remarkable increase specially POD 3. The main limitation of the study is the small number of patients. There was no statistically difference in demographic characteristics between groups. According to our results, postoperative PCT and CRP determination can be use as adecuated early predictors of anastomoticleackage from the POD 2.
La falla de sutura digestiva conlleva alta morbi-mortalidad y su diagnóstico precoz es un punto crítico y controversial. Se ha considerado necesario encontrar un marcador bioquímico de valor diagnóstico en ausencia de cuadro clínico evidente.Hay creciente evidencia de la eficacia de la Procalcitonina (PCT) y Proteína C Reactiva (PCR) como marcadores precoces de falla de sutura digestiva, porque ambas han mostrado ser útiles para la predicción de infección intrabdominal.Se realizó en el Hospital Maciel/ Clínica quirúrgica “3” (perío-do: 14 meses) , un estudio observacional, prospectivo, inclu-yendo todos los pacientes intervenidos de coordinación a los que se realizó una sutura digestiva. Se realizo la medición dia-ria de PCT y PCR pre y postoperatoria por 5 días con el objeti-vo de determinar la utilidad de ambas como indicadores preco-ces de falla de sutura. Se identificaron las complicaciones y establecieron dos grupos según la aparición o no de fuga anas-tomótica, diagnosticada clínicamente y/o imagenológicamente.Se incluyeron 28 pacientes, 14,3% presentaron falla de sutura con una mortalidad de 3,6%. Se encontró un aumento significativo de ambos marcadores en el grupo de falla de sutu-ra (PCR p=0,001yPCT p=0,003) con un aumento específico en el 3er día de postoperatorio.La limitante de nuestro estudio es el bajo número de casos, en lo cual no se encontró diferencia significativa en el resto de las variables analizadas.Este estudio permite inferir que la PCR y la PCT deben consi-derarse adecuados predictores precoces de falla de sutura y de infección intra-abdominal, a partir de las 48 hs de postoperato-rio.
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv https://revista.scu.org.uy/index.php/cir_urug/article/view/40
10.31837/cir.urug/2.2.1
dc.language.iso.none.fl_str_mv spa
dc.publisher.none.fl_str_mv Sociedad de Cirugía del Uruguay
dc.relation.none.fl_str_mv https://revista.scu.org.uy/index.php/cir_urug/article/view/40/18
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
dc.source.none.fl_str_mv Revista Cirugía del Uruguay; Vol. 2 No. 2 (2018): Cirugía del Uruguay; 2-11
Revista Cirugía del Uruguay; Vol. 2 Núm. 2 (2018): Revista Cirugía del Uruguay; 2-11
1688-1281
10.31837/cir.urug.2.2.NC
reponame:Revista Cirugía del Uruguay
instname:Sociedad de Cirugía del Uruguay
instacron:Sociedad de Cirugía del Uruguay
dc.subject.none.fl_str_mv sutura digestiva
procalcitonina
proteína C reactiva
falla de sutura
suture
calprotectin
c reactive protein
anastomotic leackage
dc.title.none.fl_str_mv Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
Procalcitonina y proteína C reactiva como marcadores precoces de falla de sutura digestiva.
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
dc.type.version.none.fl_str_mv info:eu-repo/semantics/publishedVersion
description Anastomotic leakage in digestive sutures determines high morbidity and mortality, but its early diagnoses is critical and controversial. There is an important interest on finding an early detection biomarker that allows early diagnoses without clinical evidences. Many studies have shown the eficacy of Procalcitonin (PCT) and C Reactive Protein (CRP) as early detection biomarkers of anastomotic leackeage, as they were demostrated as useful intraabdominal infection predictors. This prospective observational study took place in Hospital Maciel, Department of Surgery nº 3, in a period of 14 months, and included all patients undergoing elective surgery with a digestive suture. CRP and PCT were measured preoperatively and on postoperative days (POD) 1, 2, 3, 4, 5 and patients were followed for postoperative complications with the aim to determine if they were suitable as anastomotic leackage monitoring tool in the postoperative setting. We established two groups: with and without anastomotic leackage.28 patients were included. 14,3% corresponded to the anastomotic leackage group with a mortality of 3,6%. We found a statistically significative increase of both biomarkers in the leackage group (CRP p=0,001 and PCT p=0,003) with a remarkable increase specially POD 3. The main limitation of the study is the small number of patients. There was no statistically difference in demographic characteristics between groups. According to our results, postoperative PCT and CRP determination can be use as adecuated early predictors of anastomoticleackage from the POD 2.
eu_rights_str_mv openAccess
format article
id SCU_1_a849e982520c4fa77e67a738a614fa7b
identifier_str_mv 10.31837/cir.urug/2.2.1
instacron_str Sociedad de Cirugía del Uruguay
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publisher.none.fl_str_mv Sociedad de Cirugía del Uruguay
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spelling Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.Procalcitonina y proteína C reactiva como marcadores precoces de falla de sutura digestiva.Wagner, GabrielaValsangiacomo, PabloRodríguez Cantera, GabrielaSegura, DaisyRuso Martínez, Luissutura digestivaprocalcitoninaproteína C reactivafalla de suturasuturecalprotectinc reactive proteinanastomotic leackageAnastomotic leakage in digestive sutures determines high morbidity and mortality, but its early diagnoses is critical and controversial. There is an important interest on finding an early detection biomarker that allows early diagnoses without clinical evidences. Many studies have shown the eficacy of Procalcitonin (PCT) and C Reactive Protein (CRP) as early detection biomarkers of anastomotic leackeage, as they were demostrated as useful intraabdominal infection predictors. This prospective observational study took place in Hospital Maciel, Department of Surgery nº 3, in a period of 14 months, and included all patients undergoing elective surgery with a digestive suture. CRP and PCT were measured preoperatively and on postoperative days (POD) 1, 2, 3, 4, 5 and patients were followed for postoperative complications with the aim to determine if they were suitable as anastomotic leackage monitoring tool in the postoperative setting. We established two groups: with and without anastomotic leackage.28 patients were included. 14,3% corresponded to the anastomotic leackage group with a mortality of 3,6%. We found a statistically significative increase of both biomarkers in the leackage group (CRP p=0,001 and PCT p=0,003) with a remarkable increase specially POD 3. The main limitation of the study is the small number of patients. There was no statistically difference in demographic characteristics between groups. According to our results, postoperative PCT and CRP determination can be use as adecuated early predictors of anastomoticleackage from the POD 2.La falla de sutura digestiva conlleva alta morbi-mortalidad y su diagnóstico precoz es un punto crítico y controversial. Se ha considerado necesario encontrar un marcador bioquímico de valor diagnóstico en ausencia de cuadro clínico evidente.Hay creciente evidencia de la eficacia de la Procalcitonina (PCT) y Proteína C Reactiva (PCR) como marcadores precoces de falla de sutura digestiva, porque ambas han mostrado ser útiles para la predicción de infección intrabdominal.Se realizó en el Hospital Maciel/ Clínica quirúrgica “3” (perío-do: 14 meses) , un estudio observacional, prospectivo, inclu-yendo todos los pacientes intervenidos de coordinación a los que se realizó una sutura digestiva. Se realizo la medición dia-ria de PCT y PCR pre y postoperatoria por 5 días con el objeti-vo de determinar la utilidad de ambas como indicadores preco-ces de falla de sutura. Se identificaron las complicaciones y establecieron dos grupos según la aparición o no de fuga anas-tomótica, diagnosticada clínicamente y/o imagenológicamente.Se incluyeron 28 pacientes, 14,3% presentaron falla de sutura con una mortalidad de 3,6%. Se encontró un aumento significativo de ambos marcadores en el grupo de falla de sutu-ra (PCR p=0,001yPCT p=0,003) con un aumento específico en el 3er día de postoperatorio.La limitante de nuestro estudio es el bajo número de casos, en lo cual no se encontró diferencia significativa en el resto de las variables analizadas.Este estudio permite inferir que la PCR y la PCT deben consi-derarse adecuados predictores precoces de falla de sutura y de infección intra-abdominal, a partir de las 48 hs de postoperato-rio.Sociedad de Cirugía del Uruguay2019-07-15info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revista.scu.org.uy/index.php/cir_urug/article/view/4010.31837/cir.urug/2.2.1Revista Cirugía del Uruguay; Vol. 2 No. 2 (2018): Cirugía del Uruguay; 2-11Revista Cirugía del Uruguay; Vol. 2 Núm. 2 (2018): Revista Cirugía del Uruguay; 2-111688-128110.31837/cir.urug.2.2.NCreponame:Revista Cirugía del Uruguayinstname:Sociedad de Cirugía del Uruguayinstacron:Sociedad de Cirugía del Uruguayspahttps://revista.scu.org.uy/index.php/cir_urug/article/view/40/18info:eu-repo/semantics/openAccess2019-10-10T20:09:21Zoai:ojs2.revista.scu.org.uy:article/40Privadahttps://scu.org.uy/https://revista.scu.org.uy/index.php/cir_urug/oaiUruguayopendoar:2019-10-10T20:09:21Revista Cirugía del Uruguay - Sociedad de Cirugía del Uruguayfalse
spellingShingle Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
Wagner, Gabriela
sutura digestiva
procalcitonina
proteína C reactiva
falla de sutura
suture
calprotectin
c reactive protein
anastomotic leackage
status_str publishedVersion
title Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
title_full Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
title_fullStr Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
title_full_unstemmed Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
title_short Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
title_sort Serum procalcitonin and C reactive protein as early detectors of anatomotic leakage.
topic sutura digestiva
procalcitonina
proteína C reactiva
falla de sutura
suture
calprotectin
c reactive protein
anastomotic leackage
url https://revista.scu.org.uy/index.php/cir_urug/article/view/40