calca-protein--human and Colitis--Ischemic

Ischemic and necrotic damages are complications of digestive diseases and require emergency management. Nevertheless, the decision to surgically manage could be delayed because of no sufficiently preoperative accurate marker of ischemia diagnosis, extension, and prognosis.. The aim of this study was to assess the predictive value of serum procalcitonin (PCT) levels for diagnosing intestinal necrotic damages, their extension, and their prognosis in patients with ischemic disease including ischemic colitis and mesenteric infarction by a gray zone approach. Between January 2007 to June 2014, 128 patients with ischemic colitis and mesenteric infarction (codes K55.0 and K51.9) were operated, for whom data on PCT were available. We perform a retrospective, multicenter review of their medical records. Patients were divided into subgroups: ischemia (ID group) versus necrosis (ND group); the extension [focal (FD) vs. extended (ED)] and the vital status [deceased (D) vs. alive (A)].. PCT levels were higher in the ND (n = 94; p = 0.009); ED (n = 100; p = 0.02); and D (n = 70; p = 0.0003) groups. With a gray zone approach, the predictive thresholds were (i) for necrosis 2.473 ng/mL, (ii) for extension 3.884 ng/mL, and (iii) for mortality 7.87 ng/mL.. In our population, PCT could be used as a marker of necrosis; especially in case of extended damages and reflects the patient's prognosis.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Colitis, Ischemic; Colon; Female; Humans; Male; Mesenteric Ischemia; Middle Aged; Prognosis; Protein Precursors; Retrospective Studies; Severity of Illness Index; Survival Rate; Young Adult

We assessed serum procalcitonin (PCT) as a screening test for early detection of ischemic colitis.. Ninety-three patients (81 men and 12 women) undergoing elective aortic surgery were enrolled in this study. Their mean age was 70.3+/-8.1 years old. Serum procalcitonin was measured postoperatively.. Four patients suffered from colon ischemia. Based on a cut off value of serum PCT>/=2.0 ng/ml, fourteen patients had a false positive but none had a false negative result. Sensitivity was 100%, and specificity was 83.9% in detecting ischemic colitis. Negative predictive vale was 100%.. Serum PCT is a non-invasive test that has a high negative predictive vale in ruling out colon ischemia after aortic surgery.

Topics: Aged; Aged, 80 and over; Aortic Diseases; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Colitis, Ischemic; Early Diagnosis; Elective Surgical Procedures; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Protein Precursors; Sensitivity and Specificity; Treatment Outcome; Vascular Surgical Procedures