Serum procalcitonin correlates with colonoscopy findings and can guide therapeutic decisions in postoperative ischemic colitis

BackgroundPostoperative ischaemic colitis (POIC) is a life-threatening vascular gastrointestinal condition. Serum procalcitonin (PCT) levels be of value in the detection of necrosis.AimsTo evaluate the correlation between serum PCT levels and the colonoscopic assessment of the severity of POIC.MethodsBetween January 2007 and November 2014, 150 patients with POIC and PCT data were included in the study. The main outcome measure was the correlation between serum PCT and the colonoscopy-based assessment of the severity of POIC (according to Favier's classification: stage 1/2 without multi-organ failure vs. stage 2/3 with multi-organ failure).ResultsEighty-five percent of the stage 1 cases (n = 22) had a serum PCT level ≤2 μg/L; 63% (n = 19) of the stage 2 cases with multi-organ failure had a PCT level between 4 and 8 μg/L, and 70% (n = 52) of the stage 3 cases had a PCT level ≥8 μg/L. The PCT level was strongly correlated with the Favier stage (Spearman's rho: 0.701; p < 0.0001). PCT levels were similar in stage 2 cases with multi-organ failure and in stage 3 cases (16.06 μg/L vs. 7.79 μg/L, respectively; p = 0.35).Conclusion and relevanceSerum PCT is correlated with stage 2/3 POIC requiring surgery. If PCT ≥5 μg/L, surgery should be considered.