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Blood marker helps predict prognosis among those with abdominal infection

nfections and sepsis. Bacterial specimens were obtained from the abdomens of all participants, as were other tissue cultures when sepsis was suspected. The patients were monitored from within 96 hours of their first symptoms to a maximum of 21 days for levels of procalcitonin and another marker of inflammation, C-reactive protein, and for signs of lung or kidney failure.

Over the follow-up period, 42 patients developed lung failure, 25 developed kidney failure, 35 had multiorgan dysfunction syndrome (31 cases of which were related to sepsis) and nine died. "Procalcitonin concentrations were most closely correlated with the development of septic multi-organ dysfunction syndrome, with peak levels occurring early after symptom onset or during the immediate post-operative course," the authors write. "No such correlation was observed for C-reactive protein."

It was possible to predict multi-organ dysfunction syndrome by assessing procalcitonin levels on the first two days following surgery; those with values of 10 nanograms per milliliter on two consecutive days were at higher risk. "Persisting procalcitonin levels greater than 1 nanogram per milliliter beyond the first week after disease onset strongly indicated non-survival and were significantly better than C-reactive protein in assessing overall prognosis," they continue.

"In summary, the present prospective, international multi-center study shows that monitoring of procalcitonin levels is a fast and reliable approach to assessing severe septic complications and overall prognosis in patients with secondary peritonitis," the authors conclude. "This single-test marker improves stratification of patients who will develop clinically relevant complications."


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Contact: Bettina M. Rau
Bettina.rau@uniklinikum-saarland.de
JAMA and Archives Journals
19-Feb-2007


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