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择期心脏手术后的围手术期管理:降钙素原对感染性和非感染性并发症的预测价值。

Perioperative management after elective cardiac surgery: the predictive value of procalcitonin for infective and noninfective complications.

机构信息

Geriatrics, Università Campus Bio-Medico di Roma, Rome 00128, Italy.

Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome 00128, Italy.

出版信息

Future Cardiol. 2021 Nov;17(8):1349-1358. doi: 10.2217/fca-2020-0245. Epub 2021 Apr 20.

Abstract

Procalcitonin (PCT) has been associated with adverse outcomes after cardiac surgery. Nevertheless, there is no consensus on thresholds and timing of PCT measurement to predict adverse outcomes. A total of 960 patients undergoing elective cardiac surgery were retrospectively evaluated. PCT levels were measured from the first to the seventh postoperative day (POD). The onset of complications was recorded. Complications occurred in 421 (44%) patients. PCT on the third POD was associated with the occurrence of any kind of complications (odds ratio: 1.06; p: 0.037), and noninfectious complications (odds ratio: 1.05; p: 0.035), after adjusting. PCT above the median value at the third POD (>0.33 μg/l) predicted postoperative complications (incidence rate ratio: 1.13; p = 0.035). PCT seems to predict postoperative complications in cardiac surgery. The determination at the third POD yields the greatest sensitivity and specificity.

摘要

降钙素原 (PCT) 与心脏手术后的不良预后相关。然而,对于预测不良预后的 PCT 测量阈值和时间,尚未达成共识。

回顾性评估了 960 名接受择期心脏手术的患者。从术后第 1 天到第 7 天测量 PCT 水平。记录并发症的发生情况。

421 名(44%)患者发生并发症。调整后,第 3 天 PCT 与任何类型并发症(优势比:1.06;p:0.037)和非感染性并发症(优势比:1.05;p:0.035)的发生相关。第 3 天 PCT 中位数以上(>0.33μg/l)预测术后并发症(发病率比:1.13;p = 0.035)。

PCT 似乎可以预测心脏手术后的并发症。第 3 天的测定可获得最大的灵敏度和特异性。

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