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Rendimiento diagnóstico de la procalcitonina para detectar fuga anastomótica en adultos mayores con cáncer colorrectal

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dc.contributor.advisorIsaza Restrepo, Andrés
dc.contributor.advisorRamirez Giraldo, Camilo
dc.creatorRamírez Giraldo, Camilo
dc.creatorPesce, Antonio
dc.creatorGonzález Muñoz, Alejandro
dc.creatorNavarro, Nicolás
dc.creatorOchoa, Marian
dc.creatorVallejo Soto, Juan Carlos
dc.creatorFigueroa Avendaño, Carlos
dc.creatorIsaza Restrepo, Andrés
dc.creator.degreeEspecialista en Cirugía General
dc.creator.degreeLevelMaestría
dc.date.accessioned2025-07-28T17:54:23Z
dc.date.available2025-07-28T17:54:23Z
dc.date.created2025-06-09
dc.descriptionLa 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.
dc.description.abstractBackground: 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
dc.format.extent23 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_46160
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/46160
dc.language.isoeng
dc.publisherSurgery
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Cirugía General
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)
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dc.source.bibliographicCitationDavies J. Procalcitonin. J Clin Pathol. 2015;68(9):675–9
dc.source.bibliographicCitationSmith SE, Muir J, Kalabalik-Hoganson J. Procalcitonin in special patient populations: Guidance for antimicrobial therapy. Am J Heal Pharm. 2021;77(10):745–57
dc.source.bibliographicCitationChiarello MM, Fransvea P, Cariati M, Adams NJ, Bianchi V, Brisinda G. Anastomotic leakage in colorectal cancer surgery. Surg Oncol [Internet]. 2022;40(January):101708. Available from: https://doi.org/10.1016/j.suronc.2022.101708
dc.source.bibliographicCitationXu Z, Zong R, Zhang Y, Chen J, Liu W. Diagnostic accuracy of procalcitonin on POD3 for the early diagnosis of anastomotic leakage after colorectal surgery: A meta-analysis and systematic review. Int J Surg [Internet]. 2022;100(February):106592. Available from: https://doi.org/10.1016/j.ijsu.2022.106592
dc.source.bibliographicCitationUnited Nations Department of Economic and Social Affairs. World Social Report 2023: Leaving No One Behind in an Ageing World. United Nations [Internet]. 2023. Available from: https://www.un-ilibrary.org/content/ books/9789210019682
dc.source.bibliographicCitationIsaza-restrepo A, Ramírez-giraldo C, Venegas-sanabria LC, Rojas-lópez S. Hacia la formalización de programas para la atención quirúrgica integral del paciente anciano. Rev Colomb Cir. 2025;40(1):474–82.
dc.source.bibliographicCitationLozada-martinez ID, Sebastian J, Castelblanco-toro SM, Sarmiento M, Mazenett-granados EA, Fredy J, et al. Demographics and clinical characteristics of a new population of centenarians in Colombia . The COOLCEN cohort. Arch Gerontol Geriatr Plus. 2024;1(October 2023)
dc.source.bibliographicCitationQuiros-Roldan E, Sottini A, Natali PG, Imberti L. The Impact of Immune System Aging on Infectious Diseases. Microorganisms. 2024;12(4):1–30
dc.source.bibliographicCitationMiki C, Kusunoki M, Inoue Y, Uchida K, Mohri Y, Buckels JAC, et al. Remodeling of the immunoinflammatory network system in elderly cancer patients: Implications of inflammaging and tumor-specific hyperinflammation. Surg Today. 2008;38(10):873–8.
dc.source.bibliographicCitationFulop T, Larbi A, Dupuis G, Page A Le, Frost EH, Cohen AA, et al. Immunosenescence and inflamm-aging as two sides of the same coin: Friends or Foes? Front Immunol. 2018;8(JAN).
dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectProcalcitonina
dc.subjectCancer colorectal
dc.subjectFuga anastomosis
dc.subjectBiomarcador
dc.subject.keywordProcalcitonin
dc.subject.keywordColorectal cancer
dc.subject.keywordOlder adults
dc.subject.keywordElderly
dc.subject.keywordAnastomotic leak
dc.titleRendimiento diagnóstico de la procalcitonina para detectar fuga anastomótica en adultos mayores con cáncer colorrectal
dc.title.TranslatedTitleDiagnostic performance of procalcitonin for detecting anastomotic leak in older adults with colorectal cancer
dc.typemasterThesis
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículo
local.department.reportEscuela de Medicina y Ciencias de la Salud
local.regionesBogotá
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