Sistema Gastrointestinal e Digestivo

Abstrato

Role of Procalcitonin in the Timely Detection of Ischemia and Necrosis in Children with Intestinal Obstruction

Alfredo Domínguez-Muñoz, Roberto Dávila-Perez, Emilio Fernández-Portilla, Israel Parra-Ortega, Alfonso Reyes-López, Eduardo Bracho-Blanchet

Introduction: Procalcitonin (PCT) has been studied for early identification of Ischemia and/or Necrosis (I/N) in children with Intestinal Obstruction (IO) secondary to Adhesive Small Bowel Obstruction (ASBO). However, the causes of IO in children are numerous.

Purpose: To correlate the level of PCT with the presence of I/N.

Results: Fifty-seven patients were analyzed. The incidence of I/N was 36%. PCT median was statistically higher in patients with I/N compared to those patients with normal intestine: 4.13 (13.9) vs. 0.11 (0.28) ng/ml, p=<0.001. A PCT threshold >1.17 ng/ml for predicting I/N yielded a sensitivity of 90%, a specificity of 97%, a Positive Predictive Value (PPV) of 95%, a Negative Predictive Value (NPV) of 94%, p=<0.001, Relative Risk (RR) 17.57 (95% CI, 4.54-67.90). Similarly, a PCT threshold >1.41 ng/ml for predicting intestinal necrosis yielded a sensitivity of 92%, a specificity of 88%, a PPV of 72%, a NPV of 97%, p=<0.001, RR 28.16 (95% CI, 3.98-119.12).

Conclusion: This study corroborates the association of PCT with IN in children with IO and expands the evidence of its use in this field. Similarly, suggests a PCT threshold >1.17 ng/ml and >1.41 for predicting IN and intestinal necrosis respectively.