Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA.
Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, College of Pharmacy, Knoxville, TN, USA.
Am Surg. 2024 Sep;90(9):2338-2340. doi: 10.1177/00031348241241689. Epub 2024 Apr 3.
Procalcitonin has been investigated as a marker for bowel ischemia. This study examined the role of procalcitonin in predicting failure of non-operative management (NOM) in bowel obstructions. Patients with bowel obstructions at a single center from August 2022 to January 2023 were prospectively enrolled (n = 79). Lactic acid (LA) and procalcitonin were collected after surgical consultation. The primary outcome was success or failure of NOM. Univariate analysis, multivariable logistic regression, and performance measures of procalcitonin and LA in predicting bowel ischemia was performed. Of 79 patients included, 48 (61%) required operative intervention during index admission. There were no significant differences in demographics, comorbidities, procalcitonin, nor LA between groups. Time from last bowel movement was associated with failure of NOM (OR 1.03 [95% CI 1.01-1.06]; = .008), though initial procalcitonin or LA was not. Procalcitonin >.3 ng/mL had acceptable sensitivity in screening for bowel ischemia.
降钙素原已被研究作为肠缺血的标志物。本研究探讨了降钙素原在预测肠梗阻非手术治疗（NOM）失败中的作用。2022 年 8 月至 2023 年 1 月，在一家单中心前瞻性纳入肠梗阻患者（n = 79）。在外科会诊后采集乳酸（LA）和降钙素原。主要结局是 NOM 的成功或失败。进行了降钙素原和 LA 预测肠缺血的单因素分析、多变量逻辑回归和性能测量。在纳入的 79 例患者中，48 例（61%）在指数入院期间需要手术干预。两组间的人口统计学特征、合并症、降钙素原和 LA 无显著差异。末次排便至 NOM 失败的时间与 NOM 失败相关（OR 1.03 [95%CI 1.01-1.06]； =.008），而初始降钙素原或 LA 则不然。降钙素原>.3ng/mL 对肠缺血有较好的筛查灵敏度。
