Usefulness of presepsin for the early detection of infectious complications after elective colorectal surgery, compared with C-reactive protein and procalcitonin

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K18259
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Hirosaki University
• Principal Investigator: Nakai Kishiko 弘前大学, 医学部附属病院, 助教 (60645266)
• Project Period (FY): 2019-04-01 – 2021-03-31
• Keywords: プレセプシン / 術後感染性合併症

Outline of Final Research Achievements

Infectious complications remain a major clinical problem in colorectal surgery, contributing to prolonged hospital stays, additional costs and significant postoperative mortality. Presepsin has been reported to be a useful marker to diagnose sepsis, similar or superior to procalcitonin (PCT) and C-reactive protein (CRP), and plasma presepsin concentrations are associated with the severity of sepsis and its outcome.
The aim of this study was to assess the diagnostic value of presepsin in the early detection of infectious complications after elective colorectal surgery, compared with CRP and PCT.(601)
As a result, CRP and PCT markedly increased from POD1 to POD3 and then gradually decreased toward POD6, but the trends of the decrease in the infected group were blunt, compared with those in the non-infected group. On the other hand, presepsin did not show major changes just after surgery, but it increased on POD4 and POD6, when the complications occurred.

Free Research Field

麻酔科学

Academic Significance and Societal Importance of the Research Achievements

術後感染性合併症は、入院期間の延長や医療費の増大・死亡率の上昇に寄与するため、早期診断・治療の重要性は高いです。今回我々は、新しい感染症バイオマーカーであるプレセプシンの、下部消化管手術後の推移及び感染症の早期診断における有効性を明らかにする研究を行い、結果としてC反応性蛋白（CRP）とプロカルシトニンに術後1日目から上昇変化がみられたことに対し、プレセプシンは感染性合併症が発症してから上昇する傾向があることがわかり、以上より術後感染性合併症の診断に有用である可能性を確認しました。