P35 – Predictive value of procalcitonin for surgical site infection following Crohn’s disease resection
Background: Patients with Crohn’s disease (CD) usually receive immunosuppressants or complicating with malnutrition, which contribute to a high incidence of surgical site infection (SSI) following CD resection.
Hypothesis: Procalcitonin (PCT) is a biomarker of bacterial infection and systemic inflammation. We hypothesized that PCT may be useful for early diagnosis of SSI after CD resection.
Methods: Sixty-six patients undergoing segmental bowel resection for CD were evaluated prospectively. PCT, C-reactive protein (CRP), and white blood cell count (WBC) were measured on postoperative days (POD) 1, 2, and 3. Patients were followed for postoperative complications.
Results: Between December 2011 and October 2013, a total of 66 patients were enrolled, among which 30 (45.4%) patients received ileocaecal resection, 26 (39.4%) patients received ileocolonic resection, and 10 (15.2%) patients received partial small bowel resection. SSIs were proven in 13 (19.7%) patients, among which 10 (15.2%) patients with incisional SSI and 4 (6.1%) patients with organ/space SSI. Significant higher PCT levels (on PODs 1, 2 and 3) and CRP levels (on POD 3) were observed in patients with SSI compared to those without SSI. Receiver operating characteristic (ROC) analysis showed that PCT counts for the highest area under the curve (AUC) for predicting SSI on both PODs 1, and 2 (AUC, 0.758 and 0.750, respectively), while PCT and CRP had similar predictive values for the development of SSI on POD 3 (AUC, 0.734 and 0.739, respectively).
Conclusions: Compared with conventional inflammatory markers, PCT is more reliable in detecting SSI on early postoperative days after CD resection.