Document Detail

Postoperative serum pro-calcitonin and C-reactive protein levels in patients with orthopedic infections.
MedLine Citation:
PMID:  21104474     Owner:  NLM     Status:  MEDLINE    
QUESTIONS UNDER STUDY / PRINCIPLES: The value of postoperative pro-calcitonin (PCT) in the follow-up of patients with localised infections in the orthopaedic domain is unknown.
METHODS: We conducted a retrospective study comparing postoperative ultra-sensitive serum PCT (upper normal level 0.25 µg/l) and C-reactive protein (CRP; upper normal level 10 mg/l) levels in adult patients with localised non-bacteremic orthopaedic infections.
RESULTS: A total of 165 paired PCT and CRP samples were retrieved from 60 infected patients. PCT levels exceeded normal in only half of the patients and practically only on the first postoperative day, despite a clinically active infection in all cases. PCT values did not differ between patients with or without surgical re-interventions (36 patients; median 0.09 mg/l vs. 24 patients; median 0.08 µg/l; Wilcoxon-rank sum-test, p = 0.34). CRP was elevated in 54 patients (90%) with a maximum at day 2, and normalised by the tenth day. Both markers correlated poorly with each other (Kendall-tau-test 0.47). The cost for one analysis (phlebotomy by nurses, transport and laboratory) was US$70 for PCT and $20 for CRP.
CONCLUSIONS: Postoperative serum PCT levels in orthopaedic infections were rarely elevated, even if patients continued to be infected. They quickly fell to within a normal range at day 2. PCT does not seem to be better than the less expensive CRP in the follow-up of these patients.
Ilker Uçkay; Christian Garzoni; Tristan Ferry; Stephan Harbarth; Richard Stern; Mathieu Assal; Pierre Hoffmeyer; Daniel Lew; Louis Bernard
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-11-19
Journal Detail:
Title:  Swiss medical weekly     Volume:  140     ISSN:  1424-3997     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-02-01     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  w13124     Citation Subset:  IM    
Orthopedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211 Geneva 14, CH.
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MeSH Terms
Bacterial Infections / blood*,  etiology
C-Reactive Protein / analysis*
Calcitonin / blood*
Middle Aged
Orthopedic Procedures / adverse effects*
Postoperative Period
Prosthesis-Related Infections / blood
Protein Precursors / blood*
Retrospective Studies
Soft Tissue Infections / blood,  etiology
Reg. No./Substance:
0/Protein Precursors; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin; 9007-41-4/C-Reactive Protein

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