Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 30;25(1):338.
doi: 10.1186/s12872-025-04654-3.

Procalcitonin as a biomarker for postoperative pneumonia: a study on dynamics following cardiopulmonary bypass in adults

Guang-Xu Mao  1   2 , Li-Yun Wang  1 , Wen-Sen Chen  1 , Sheng Zhao  3 , Yong-Feng Shao  3 , Yu-Zhen Guan  3 , Zhen Lu  3 , Feng Zang  4
Affiliations

Procalcitonin as a biomarker for postoperative pneumonia: a study on dynamics following cardiopulmonary bypass in adults

Guang-Xu Mao et al. BMC Cardiovasc Disord. .

Abstract
in English, German

Objective: Postoperative pneumonia (POP) frequently complicates cardiac surgery that involves cardiopulmonary bypass (CPB). This study aimed to assess the diagnostic utility of procalcitonin (PCT) for identifying pneumonia after CPB-assisted cardiac surgery.

Methods: Patients diagnosed with POP were enrolled in the retrospective matched case-control study and were admitted to a Grade III general hospital in Nanjing in 2023. POP diagnosis was determined based on a combination of clinical and microbiological criteria.PCT and white blood cell count (WBC) data were systematically collected from day 1 (T1) to day 5 (T5). Receiver operating characteristic (ROC) curve analysis and subject operating characteristics were utilized to evaluate the diagnostic performance of biomarkers. At the same time, a binary logistic regression model was developed to identify factors that influence the diagnosis of POP.

Results: The study included 220 age- and sex-matched patients, comprising 56 individuals with POP and 164 uninfected patients constituting the non-POP group. ROC curve analysis revealed that serum PCT concentration exhibited an AUC > 0.7 from day 2 to day 5, whereas other indices demonstrated AUCs < 0.7 at these time points. Univariate and multivariate analyses highlighted serum PCT concentration on day 2, WBC count on day 5, the PCTT4-T1 variation rate, and days of mechanical ventilation as significant predictive factors for POP diagnosis, each demonstrating statistical significance (P < 0.05). The calculated AUC was 0.837 (95%CI: 0.773-0.902). The absolute PCT value exhibited superior diagnostic performance relative to its variance rate and WBC count, yielding optimal diagnostic accuracy with a cutoff value of 3.45 ng/ml.

Conclusion: Serum PCT absolute value demonstrates higher sensitivity and specificity than other indices, offering superior diagnostic potential for predicting POP.

Procalcitonin (PCT) levels showed promise as a sensitive and specific marker for predicting postoperative pneumonia (POP) following cardiac surgery with cardiopulmonary bypass (CPB).

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: The study was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (ethics number: 2024-SR-535). All patients participating in the study signed the informed consent form. Consent for publication: All authors agree to and support the article’s submission and publication. The anonymity of the study will not be compromised by any participants’ images or other personal or clinical details. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kinetic changes in PCT (A), WBC (B), and PCT variability (C) in the POP group (solid line) and uninfected patients (dashed line) over the five postoperative days, with asterisks denoting statistical differences between groups (P < 0.05)
Fig. 2
Fig. 2
Comparison of ROC curves showing the predictive value of PCT (value on T2), PCT variation (value on T2), and CRP (value on T5) for the diagnosis of POP
Fig. 3
Fig. 3
ROC curve
Fig. 4
Fig. 4
Calibration curve
Fig. 5
Fig. 5
Comparison of different clinical outcomes between the two groups (red asterisks represent statistical differences between groups (P < 0.001))
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Gerstein NS, Panikkath PV, Mirrakhimov AE, Lewis AE, Ram H. Cardiopulmonary bypass emergencies and intraoperative issues. J Cardiothorac Vasc Anesth. 2022;36(12):4505–22. - PubMed
    1. Kallel S, Abid M, Jarraya A, Abdenadher M, Mnif E, Frikha I, et al. [Kinetics, diagnostic and prognostic value of procalcitonin after cardiac surgery]. Ann Biol Clin (Paris). 2012;70(5):567–80. - PubMed
    1. Chen W, Zhong K, Guan Y, Zhang HT, Zhang H, Pan T, et al. Evaluation of the significance of interleukin-6 in the diagnosis of postoperative pneumonia: a prospective study. BMC Cardiovasc Disord. 2022;22(1):306. - PMC - PubMed
    1. Aïssou L, Sorbets E, Lallmahomed E, Goudot F-X, Pop N, Es-Sebbani S, et al. Prognostic and diagnostic value of elevated serum concentration of procalcitonin in patients with suspected heart failure. A review and meta-analysis. Biomarkers. 2018;23(5):407–13. - PubMed
    1. Sager R, Kutz A, Mueller B, Schuetz P. Procalcitonin-guided diagnosis and antibiotic stewardship revisited. BMC Med. 2017;15(1):15. - PMC - PubMed

LinkOut - more resources