TY - JOUR
T1 - Role of serum procalcitonin in predicting the surgical outcomes of acute calculous cholecystitis
AU - Fransvea, Pietro
AU - Covino, Marcello
AU - Rosa, Fausto
AU - Puccioni, Caterina
AU - Quero, Giuseppe
AU - Cozza, Valerio
AU - La Greca, Antonio
AU - Franceschi, Francesco
AU - Alfieri, Sergio
AU - Sganga, Gabriele
PY - 2021
Y1 - 2021
N2 - Background: Acute calculous cholecystitis (AC) is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. In the preoperative planning, the severity of AC should be considered as well as time of onset of symptoms and patient comorbidities. The aim of the present study was to investigate the role of an early PCT assessment in the emergency department in predicting the outcomes of laparoscopic surgery for AC. Study design: Retrospective, mono-centric study conducted in a teaching urban hospital. We evaluated all patients admitted to our ED from January 1st, 2015, to December 31st, 2019, underwent laparoscopic cholecystectomy for AC having a preoperative PCT determination in ED. Results: A total of 2285 patients in our ED were admitted for AC. Among them 822 patients were treated surgically, 174 had a PCT determination in ED. Median age was 63 [50–74]. Overall, 33 patients (19.0%) had major complications (MC): 32 needed an open surgery conversion, and 3 among them deceased. Multivariate analysis demonstrated that PCT, WBC, BUN, and CCI were significantly associated to MC in our cohort. When we calculated the area under the ROC curve with regard to MC, a procalcitonin value > 0.09 at admission had sensitivity = 84.8% [68.1–94.9] and specificity = 51.8% [43.2–60.3] for the occurrence of MC. Conclusion: Our results, suggest that a PCT > 0.09 ng/mL at ED admission, could be associated to a poor surgical outcome in patients treated by laparoscopic surgery for AC.
AB - Background: Acute calculous cholecystitis (AC) is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. In the preoperative planning, the severity of AC should be considered as well as time of onset of symptoms and patient comorbidities. The aim of the present study was to investigate the role of an early PCT assessment in the emergency department in predicting the outcomes of laparoscopic surgery for AC. Study design: Retrospective, mono-centric study conducted in a teaching urban hospital. We evaluated all patients admitted to our ED from January 1st, 2015, to December 31st, 2019, underwent laparoscopic cholecystectomy for AC having a preoperative PCT determination in ED. Results: A total of 2285 patients in our ED were admitted for AC. Among them 822 patients were treated surgically, 174 had a PCT determination in ED. Median age was 63 [50–74]. Overall, 33 patients (19.0%) had major complications (MC): 32 needed an open surgery conversion, and 3 among them deceased. Multivariate analysis demonstrated that PCT, WBC, BUN, and CCI were significantly associated to MC in our cohort. When we calculated the area under the ROC curve with regard to MC, a procalcitonin value > 0.09 at admission had sensitivity = 84.8% [68.1–94.9] and specificity = 51.8% [43.2–60.3] for the occurrence of MC. Conclusion: Our results, suggest that a PCT > 0.09 ng/mL at ED admission, could be associated to a poor surgical outcome in patients treated by laparoscopic surgery for AC.
KW - Acute cholecystitis
KW - Cholecystectomy, Laparoscopic
KW - Cholecystitis
KW - Cholecystitis, Acute
KW - Humans
KW - Middle Aged
KW - Procalcitonin
KW - Retrospective Studies
KW - Surgical outcomes
KW - Treatment Outcome
KW - Acute cholecystitis
KW - Cholecystectomy, Laparoscopic
KW - Cholecystitis
KW - Cholecystitis, Acute
KW - Humans
KW - Middle Aged
KW - Procalcitonin
KW - Retrospective Studies
KW - Surgical outcomes
KW - Treatment Outcome
UR - http://hdl.handle.net/10807/199745
U2 - 10.1007/s00423-021-02252-3
DO - 10.1007/s00423-021-02252-3
M3 - Article
SN - 0023-8236
VL - 406
SP - 2375
EP - 2382
JO - LANGENBECKS ARCHIV FUER CHIRURGIE
JF - LANGENBECKS ARCHIV FUER CHIRURGIE
ER -