Prognostic Value of Serum Procalcitonin After Orthopedic Surgery in the Elderly Population - Biological Adaptation and Ageing Accéder directement au contenu
Article Dans Une Revue Journals of Gerontology Series A: Biological Sciences and Medical Sciences Année : 2017

Prognostic Value of Serum Procalcitonin After Orthopedic Surgery in the Elderly Population

Helene Vallet
Camille Chenevier-Gobeaux
  • Fonction : Auteur
Cedric Villain
Judith Cohen-Bittan
  • Fonction : Auteur
Patrick Ray
  • Fonction : Auteur
Loïc Epelboin
Bruno Riou
Frederic Khiami
  • Fonction : Auteur
Jacques Boddaert

Résumé

Background: Orthopedic surgery is more and more frequent in the older patients and is associated with a high mortality rate. Although serum procalcitonin levels are associated with prognosis in young adults, data are still lacking in the elderly population, and especially after surgery. The main objective of this study was to determine the prognostic value of procalcitonin levels in a large geriatric orthopedic population, and we compared it with clinical variables and biomarkers. Methods: This is a prospective study including patients admitted in our dedicated geriatric postoperative unit, after orthopedic surgery with immediate postoperative measured procalcitonin levels. Collected data included age, sex, medical history, functional status (activities of daily living [ADL]), fracture type, Cumulative Illness Rating scale (CIRS), postoperative complications, and biological data. The primary endpoint was the 30-day mortality. Results: 436 patients (age 85 +/- 6 years) were included. Hip fracture surgery was the most frequent (n = 310; 71%), and the 30-day mortality rate was 6.9%. Compared with C-reactive protein (CRP), albumin, CIRS, and ADL, procalcitonin had the highest area under the receiver operating characteristic curve for predicting 30-day mortality (0.74; 95% CI: 0.70-0.78). Using a cutoff at 1 mu g/L, procalcitonin was more specific than CIRS to predict 30-day mortality (92 vs 77%; p <.001). In a multivariable analysis, procalcitonin level higher than 0.39 mu g/L is a significant predictor of mortality within 30 days (odds ratio 3.84; 95% CI: 1.61-9.14, p =.002). Conclusion: Elevated procalcitonin values were strongly and significantly associated with mortality within 30 days in older patients after orthopedic surgery.

Dates et versions

hal-01545497 , version 1 (22-06-2017)

Identifiants

Citer

Helene Vallet, Camille Chenevier-Gobeaux, Cedric Villain, Judith Cohen-Bittan, Patrick Ray, et al.. Prognostic Value of Serum Procalcitonin After Orthopedic Surgery in the Elderly Population. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2017, 72 (3), pp.438-443. ⟨10.1093/gerona/glw097⟩. ⟨hal-01545497⟩
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