Postoperative plasma concentrations of procalcitonin after different types of surgery

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Abstract
Objective: Procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations were measured after different types of surgery to analyze a possible postoperative induction of procalcitonin (PCT), which might interfere with the diagnosis of bacterial infection or sepsis by PCT. Design: PCT and CRP plasma levels as well as clinical symptoms of infection were prospectively registered preoperatively and 5 days postoperatively. Setting: University hospital, in-patient postoperative care. Patients: Hundred thirty patients were followed up; 117 patients with a normal postoperative course were statistically analyzed. Interventions: None. Measurements and results: PCT concentrations were moderately increased above the normal range in 32 % of patients after minor and aseptic surgery, in 59 % after cardiac and thoracic surgery, and in 95 % of patients after surgery of the intestine. In patients with an abnormal postoperative course, PCT was increased in 12 of 13 patients. CRP was increased in almost all patients. Conclusions: Postoperative induction of PCT largely depends on the type of surgery. Intestinal surgery and major operations more often increase PCT, whereas it is normal in the majority of patients after minor and primarily aseptic surgery. PCT can thus be used postoperatively for diagnostic means only when the range of PCT concentrations during the normal course of a certain type of surgery is considered and concentrations are followed up.