Kinetics of C-reactive protein and procalcitonin after scoliosis surgery

Abstract

Introduction. Post-surgery systemic inflammatory response syndrome leads to an elevation in C reactive protein (CRP) and procalcitonin (PCT) levels which may impede their diagnostic value for postoperative infection. The aim of this study is to establish the kinetics of both markers after scoliosis surgery.
Methods. Prospective observational study setting in an eight-bed pediatric intensive care unit of a university hospital. Twenty-nine children were included. CRP and PCT levels were determined at 0, 24, 48 y 72 h after scoliosis surgery.
Results. PCT levels increased early after surgery with a maximum peak at 24 hours (mean: 0.41 ng/ml; IC 95% 0.11-0.71 ng/ml) that is below the cutoff values for local infection or sepsis diagnosis (0.79 and 1.8 ng/ml respectively) previously established in our pediatric intensive care unit. However, C reactive protein increased later, reached the higher peak at 48 hours (mean: 12.23 mg/dl IC 95% 5.61-18.86 mg/dl) that is above cutoff values for sepsis and local infection (5.7 and 6.45 mg/dl respectively) previously established in our pediatric intensive care unit.
Conclusion. Procalcitonin seems to be a more reliable diagnosis tool of postoperative scoliosis infection due to its earlier elevation and the maintenance of its levels below the cut-off value for infection.