To Investigate Diagnostic Significance Of Serum Procalcitonin On Postoperation Infection In Patients With Fractures

Objective: To monitor plasma procalcitonin (PCT) levels in the postoperativeinfection patients with fractures and evaluate its diagnostic value for bacterial infections．Methods: A total of153patients with complete clinical data with femoral neckfractures or femoral intertrochanteric fractures treated by open reduction and internalfixation from June2012to December2013were included in the study. They were72males and81females, aged from65years to99years (average,77.8years). Routine bloodsamples, for determining PCT level, CRP plasma concentration, and white blood cell count,were obtained on preoperative day1, postoperative days1,3and5. Predictive values foreach of the laboratory markers were examined.Results: Infection was diagnosed in11(7.19%) of153patients. Patients with SSIexhibited significantly higher PCT levels (on PODs3and5) and CRP levels (on POD5)than did patients without SSI. According to receiver operating characteristic analysis, PCTshowed the highest area under the curve (AUC) for predicting SSI on both PODs3and4(AUC,0.78and0.76, respectively). Multivariate logistic regression analysis showed thatPCT (on PODs3and5) was an independent predictor for SSI (odds ratio=14.42and9.61,respectively).Conclusion: Serum PCT is more reliable laboratory marker for the early diagnosis ofinfection patients after fracture operation, compared with conventional inflammatoryindicators.PCT could serve as an additional diagnostic tool for the early identification ofSSI to improve clinical decision making.