Ítem
Acceso Abierto
Rendimiento diagnóstico de la procalcitonina para detectar fuga anastomótica en adultos mayores con cáncer colorrectal
Título de la revista
Autores
Ramírez Giraldo, Camilo
Pesce, Antonio
González Muñoz, Alejandro
Navarro, Nicolás
Ochoa, Marian
Vallejo Soto, Juan Carlos
Figueroa Avendaño, Carlos
Isaza Restrepo, Andrés
Fecha
2025-06-09
Directores
Isaza Restrepo, Andrés
Ramirez Giraldo, Camilo
ISSN de la revista
Título del volumen
Editor
Surgery
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Resumen
La utilidad de la procalcitonina para detectar fugas anastomóticas tras la cirugía colorrectal en adultos mayores no ha sido bien documentada. Dado que el sistema inmunitario experimenta cambios con la edad, los niveles basales de procalcitonina pueden diferir, y su eficacia diagnóstica podría variar cuando se produce una fuga anastomótica tras la cirugía colorrectal en pacientes mayores con cáncer. El objetivo de este estudio es evaluar la eficacia diagnóstica de la procalcitonina al tercer día postoperatorio para detectar fugas anastomóticas en adultos mayores con cáncer colorrectal.
Abstract
Background: The utility of procalcitonin for detecting anastomotic leaks after colorectal surgery in older adults has not been well documented. As the immune system undergoes changes with age, procalcitonin levels may differ at baseline, and its diagnostic performance could vary when an anastomotic leak occurs after colorectal surgery in older adult patients with cancer. The aim of this study is to evaluate the diagnostic performance of procalcitonin on postoperative day 3 for detecting anastomotic leaks in older adults with colorectal cancer. Methods: We conducted a diagnostic test study on the basis of a delayed-type cross-sectional design in older adults (≥65 years old) with colorectal cancer. Postoperative day 3 procalcitonin levels were tested. The reference standard was anastomotic leak. We calculated the receiver operating characteristic curve and its area under the curve. Results: The incidence of anastomotic leak was 7.7%. On postoperative day 3, the receiver operating characteristic demonstrated an area under the curve of 0.68 (95% confidence interval, 0.58-0.78) for the prediction of an anastomotic leak using procalcitonin levels. The cutoff point with the greatest diagnostic performance, according to the Youden index, was 0.61 ng/mL, with a sensitivity of 0.69, specificity of 0.62, a positive likelihood ratio of 1.86, and a negative likelihood ratio of 0.48 for predicting an anastomotic leak. The area under the curve was 0.78 when ileostomies were excluded and 0.81 when evaluating grade C leaks. Conclusion: Our study reveals that procalcitonin levels on postoperative day 3 are a poor diagnostic marker for identifying anastomotic leaks in older adults with colorectal cancer, with an improvement in performance for the grade C anastomotic leak subgroup
Palabras clave
Procalcitonina , Cancer colorectal , Fuga anastomosis , Biomarcador
Keywords
Procalcitonin , Colorectal cancer , Older adults , Elderly , Anastomotic leak
