[Procalcitonin as sepsis predictor in cardiovascular surgery with cardiopulmonary bypass].

Alma Ivette Carrasco-Castilla, María Del Carmen Jiménez-González, Edgar Cruz-García, Gerardo Gutiérrez-Tovar, Angélica Atzin Cedillo-López, María Elena Rosalba Rodríguez-López, Iván de Jesús Ascencio-Montiel
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Abstract

Background: Cardiopulmonary bypass generates an exacerbated response that may lead to sepsis.

Objective: To describe the association between procalcitonin levels and sepsis diagnosis in cardiovascular surgery subjects with cardiopulmonary bypass.

Methods: A case-series study was conducted in 142 patients. Serum procalcitonin levels were measured at 24 hours and at 72 hours after surgery using a point of care testing based on quantitative immunochromatographic method. To assess association between procalcitonin levels and sepsis status, we calculated area under the curve (AUC) and sensitivity, specificity, and predictive values for the best cut-off point.

Results: From 142 patients studied, 7 developed sepsis after surgery (4.9%). For 24-hours procalcitonin levels AUC was 0.921 and best cut-off point was 3.8 ng/mL (sensitivity 0.857 and specificity 0.904). In the case of 72-hours procalcitonin levels, we observed a value of 0.868 for AUC and best cut-off point was 8.4 ng/mL (sensitivity 0.86 and specificity 0.97).

Conclusions: Procalcitonin levels at 24 and 72 hours after cardiovascular surgery with cardiopulmonary bypass are associated with sepsis presence at cut-off points of 3.8 and 8.4 ng/mL respectively.

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[降钙素原作为心血管手术伴体外循环脓毒症的预测因子]。
背景:体外循环产生加重的反应,可能导致败血症。目的:探讨体外循环心血管手术患者降钙素原水平与脓毒症诊断的关系。方法:对142例患者进行病例系列研究。采用基于定量免疫层析法的护理点测试,在术后24小时和72小时测量血清降钙素原水平。为了评估降钙素原水平与脓毒症状态之间的关系,我们计算了曲线下面积(AUC)以及最佳截断点的敏感性、特异性和预测值。结果:142例患者中,7例术后发生脓毒症(4.9%)。24小时降钙素原水平AUC为0.921,最佳临界值为3.8 ng/mL(敏感性0.857,特异性0.904)。在72小时降钙素原水平的情况下,我们观察到AUC的值为0.868,最佳截断点为8.4 ng/mL(敏感性0.86,特异性0.97)。结论:心血管手术合并体外循环后24小时和72小时降钙素原水平与脓毒症存在相关,临界值分别为3.8和8.4 ng/mL。
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