Predictive value of procalcitonin for intestinal ischemia and/or necrosis in pediatric patients with adhesive small bowel obstruction (ASBO).
J Pediatr Surg
; 52(10): 1616-1620, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-28735976
ABSTRACT
PURPOSE:
Evaluate serum procalcitonin (PCT) level as a predictor of intestinal ischemia or necrosis (IN) in patients with postoperative adhesive small bowel obstruction (ASBO).METHODS:
Prospective cohort of consecutive patients with ASBO. Patients previously treated with antibiotics or septic were excluded. PCT was measured at the diagnosis of ASBO and every 24 h afterwards. MAINOUTCOME:
intestinal ischemia or necrosis (IN).RESULTS:
Fifty-nine patients were included, 12 of whom were excluded; 47 patients remained in the study; male-to-female ratio = 1.91. MANAGEMENT medical in 15 cases (32%) and surgical in 32 (68%). MAINOUTCOME:
Intestinal necrosis (IN) in 10 patients (21.3%). Mean PCT level was higher in patients with IN (15.11 ng/ml vs. 0.183 ng/ml, p=0.002), the proportion of patients with elevated PCT (>0.5 ng/dl) was higher in patients with IN (70% vs. 8.1%, p=<0.001, RR=26.4 with a 95% CI of 4.39-159.5). Elevated PCT levels at diagnosis had a 70% positive predictive value (PPV) and 91.8% negative predictive value (NPV) for prediction of IN. With a PCT value at diagnosis of >1.0 ng/dl, PPV was 87.5% and NPV, 92.3%.CONCLUSIONS:
PCT levels are closely related to the presence of intestinal ischemia and necrosis in children with ASBO. LEVEL OF EVIDENCE Study of Diagnostic Test, Level II.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Calcitonina
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Peptídeo Relacionado com Gene de Calcitonina
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Obstrução Intestinal
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Isquemia
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article