Predictive value of procalcitonin for postoperative surgical site infection after definitive operation of intestinal fistula        REN Hua-jian，LI Guan-wei，WANG Ge-fei，et al. Research Institute of General Surgery，Nanjing General Hospital of Nanjing Military Command，PLA, Nanjing 210002，China
Corresponding author：REN Jian-an，E-mail：jan@medmail.com.cn
Abstract    Objective    To explore the predictive value of dynamic testing procalcitonin (PCT) in postoperative surgical site infection (SSI) after definitive operation of intestinal fistula. Methods    Definitive reconstruction operation of digestive tract was performed in 62 patients with intestinal fistula between February 2012 and October 2013 in Nanjing General Hospital of Nanjing Military Command. Patients with and without SSI were classified as infection group (22 cases) and normal group (40 group). PCT level，C-reactive protein level and white blood cell count were assessed preoperatively and on the 1st，3rd，5th and 7th day postoperatively. The relationship between PCT value and SSI after operation was evaluated. Results    The median time when SSIs were diagnosed clinically was 6.1 days after surgery. PCT values in infection group were signi?cantly higher than those in normal group on postoperative 3rd and 5th day (P<0.05). C-reactive protein levels on postoperative 7th day in infection group were higher than those in normal group (P<0.05). White blood cell counts on postoperative 5th, 7th day in infection group were higher than those in normal group (P<0.05). Receiver-operating characteristics demonstrated that PCT had the highest diagnostic accuracy with a value more than 0.97 μg/L on postoperative 3rd day. The area under the curve (AUC) of PCT for SSI was 0.83 with 77.3% sensitivity and 87.5% specificity. In a multivariate logistic regression analysis，PCT level more than 0.97 μg/L on postoperative 3rd day was a signi?cant predictor for postoperative SSI on with an odds ratio of 27.76 (95% CI=6.17～124.90，P<0.001). Conclusion    The dynamic change of PCT is valuable to predict the occurrence of SSI after definitive operation of intestinal fistula.