Diagnostic value of PCT in detecting early postoperative infectious fever in spine surgery with implant

Objective To evaluate the value of procalcitonin (PCT) in detecting infection among patients with fever after spine surgery with implants. Methods Clinical data about a total of 101 patients received spine surgery and developed postoperative fever (within 10 d) in Chinese PLA General Hospital from January 2013 to January 2015 were analyzed retrospectively. The patients were divided into infection group (group A, n=40) and non-infection group (group B, n=61) according to the Golden Standard (blood culture results). PCT, CRP and ESR were tested before surgery, during fever and the differences between two groups were compared. The diagnostic value of PCT on early infectious fever was analyzed and its optimal threshold value was evaluated by receiver operating characteristics (ROC) curve. Results All indicators increased significantly after surgery in both two groups (P< 0.05). PCT and CRP were higher in group A than group B, while the difference in ESR was not significant (P> 0.05). The area under ROC curve of PCT (0.861, 95% CI:0.77-0.94, P=0.000) was bigger than CRP (0.689, 95% CI:0.58-0.79, P=0.001). The optimal cutoff point of PCT to detect infection was 0.47 ng/ml. Conclusion Serum PCT is a reliable biological marker to detect early postoperative infectious complications in spinal surgery with implant.