Barnes Alex, Spizzo Paul, Mountifield Réme
Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Intern Med J. 2022 Mar;52(3):436-439. doi: 10.1111/imj.15086.
Faecal calprotectin (FCP) is a highly sensitive non-invasive marker of intestinal inflammation that has evidence-based roles in outpatient diagnosis and management of inflammatory bowel disease.
To examine indications for FCP in a tertiary inpatient population and its role in inpatient management and subsequent investigations.
An electronic database was used to identify all patients over the age of 18 years who had FCP performed during a hospital admission over a 3-year period from March 2016 to the end of March 2019. Electronic records and case notes were reviewed with follow up to March 2020, seeking indication for testing, healthcare units requesting, and subsequent investigations and treatment resulting from FCP.
Over a 3-year period, 111 FCP inpatient results were identified. There were three changes in management based on the FCP result that led to further investigations that did not lead to any clinically significant pathology. There was no observable difference in the number of colonoscopies performed based on FCP level. The numerical FCP value was associated with clinically significant findings on colonoscopy. Negative predictive value of FCP level (≤50 μg/g) for clinically significant finding on colonoscopy was 64%.
Non-guideline-based hospital inpatient usage of FCP rarely changes inpatient management and had no observable difference in the usage of subsequent diagnostic colonoscopy. Regardless, the FCP level remained a strong predictor of clinically significant pathology on colonoscopy.
粪便钙卫蛋白（FCP）是肠道炎症的一种高度敏感的非侵入性标志物，在炎症性肠病的门诊诊断和管理中具有循证作用。
研究FCP在三级住院患者中的应用指征及其在住院管理和后续检查中的作用。
使用电子数据库识别2016年3月至2019年3月底3年期间住院期间进行FCP检测的所有18岁以上患者。回顾电子记录和病例记录，随访至2020年3月，寻找检测指征、申请检测的医疗单位以及FCP检测后的后续检查和治疗情况。
在3年期间，共识别出111例FCP住院检测结果。基于FCP结果有3例管理变更，导致进一步检查，但未发现任何具有临床意义的病理情况。基于FCP水平进行的结肠镜检查数量没有明显差异。FCP数值与结肠镜检查的临床显著发现相关。FCP水平（≤50μg/g）对结肠镜检查临床显著发现的阴性预测值为64%。
基于非指南的医院住院患者使用FCP很少改变住院管理，且在后续诊断性结肠镜检查的使用上没有明显差异。尽管如此，FCP水平仍然是结肠镜检查临床显著病理情况的有力预测指标。
