Article

Prospective, nonrandomized, observational cohort study. OBJECTIVES:
To analyze procalcitonin (PCT) level in acute traumatic spinal cord injury
patients with and without postoperative infectious complications, and to
determine whether PCT is a prognostic parameter of infectious complications in
the early postoperative period compared with other inflammatory markers. SETTING:
Spine center of Chongqing, China; Trauma center of Chinese People's Liberation
Army, China. METHODS: A total of 339 consecutive patients with acute spinal cord
injury undergone surgery were evaluated. All patients underwent measurement of
leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP),
and serum PCT preoperatively and 24-48 h postoperatively. RESULTS: In all, 26
(7.7%) of 339 participants experienced postoperative infectious complication.
Patients with infection exhibited significantly higher PCT and CRP levels
compared with noninfection (both P<0.01). Multivariate logistic regression
analysis showed that PCT and CRP levels were independent predicators for
postoperative infection. The area under the receiver operating characteristics
curve of PCT and CRP were 0.82 (95% confidence intervals (CI) 0.74-0.91) and 0.68
(95%CI, 0.57-0.78), respectively. A PCT cutoff of 0.1 ng ml(-1) had a reasonable
sensitivity of 92% to exclude an infection and antibiotics can be initially
withheld. However, in patients with PCT level above 0.5 ng ml(-1), a rapid
initiation of antibiotics may be warranted. CONCLUSIONS: Serum PCT is a more
reliable biologic marker for the early prediction of postoperative infectious
complications in patients with acute traumatic spinal cord injury compared with
CRP. PCT can early identify postoperative infections for establishing effective
antibiotic therapy.

Langue : ANGLAIS