The prognostic value of Pro-Calcitonin, CRP and thyroid hormones in secondary peritonitis;A single-center prospective study

BACKGROUND: Infections and sepsis remain the leading cause of morbidity and mortality in secondary peritonitis. Clinicians are still challenged with the task of finding an early and reliable diagnosis of septic complications. We evaluated the role of inflammatory markers (Procalcitonin (PCT), C-reactive protein (CRP) and thyroid hormones in determining the severity of secondary peritonitis.

METHODS: Pre and postoperative days 1-3-5-7-14 PCT, CRP and thyroid hormone concentrations were measured in serum from 84 consecutive patients who were operated on for secondary peritonitis between January 2008 and January 2010. All data was entered and analyzed using the Statistical Package for Social Sciences, version 15.0 and clinical parameters compared using the student’s t test.

RESULTS: For the groups diagnosed with perforated viscus, PCT concentrations were significantly low in contrast to high thyroid hormone levels in patients who developed postoperative complications or died when compared to patients whose postoperative course were uneventful or discharged. The PCT concentration significantly correlated with the CRP concentration and WBC count.

CONCLUSION: In the absence of postoperative complications, PCT is a better predictor of outcome than CRP in secondary peritonitis. Our study showed that a low thyroid hormone level can serve as an important prognostic parameter of disease severity in secondary peritonitis.