Procalcitonin as an early predictive marker for infectious complications after hepatectomy

Abstract

Abstract Purpose: The present study aimed to determine the clinical value of serum procalcitonin (PCT) levels for predicting postoperative infections after hepatectomy. Methods: The medical records of 301 consecutive patients who underwent a hepatectomy were retrospectively reviewed. We divided the patients into a postoperative infectious complication group and a no-infectious complication group. We investigated the changes in perioperative inflammatory markers, such as C-reactive protein (CRP) and PCT. Then, the associations between infectious complication and the perioperative inflammatory markers were evaluated to identify factors predictive of infectious complications after hepatectomy. Results: Postoperative infectious complications occurred in 67 patients (22.3%). The area under the curve (AUC) using PCT on postoperative day (POD) 1 and 3 was 0.794 and 0.845, respectively, while CRP was 0.493 and 0.641, respectively. PCT had a better AUC than CRP in predicting postoperative infectious complications on POD 1 and 3 (p<0.001). A multivariate analysis indicated that PCT levels on POD 1 and 3 were independent predictors of infectious complications after hepatectomy (p= 0.048 and 0.013, respectively). Conclusion: PCT is a better marker for predicting infectious complications than CRP. The PCT levels on POD 1 and 3 after hepatectomy are a valuable indicator of infectious complications.