Background: Procalcitonin (PCT) is a biomarker for sepsis, but its utility has not been investigated in necrotizing enterocolitis (NEC). Necrotizing enterocolitis is a devastating multisystem disease of infants that in severe cases requires surgical intervention. We hypothesize that an elevated PCT will be associated with surgical NEC.Patients and Methods: After obtaining Institutional Review Board (IRB) approval (#12655), we performed a single institution retrospective case control study between 2010 and 2021 of infants up to three months of age. Inclusion criteria was PCT drawn within 72 hours of NEC or sepsis diagnosis. Control infants had a PCT drawn in the absence of infectious symptoms. Recursive partitioning (RP) identified PCT cutoffs. Categorical variable associations were tested using Fisher exact or chi(2) tests. Continuous variables were tested using Wilcoxon rank sum test, Student t-test, and Kruskal-Wallis test. Adjusted associations of PCT and other covariables with NEC or sepsis versus controls were obtained via multinomial logistic regression analysis.Results: We identified 49 patients with NEC, 71 with sepsis, and 523 control patients. Based on RP, we selected two PCT cutoffs: 1.4 ng/mL and 3.19 ng/ml. A PCT of >= 1.4 ng/mL was associated with surgical (n = 16) compared with medical (n = 33) NEC (87.5 vs. 39.4; p = 0.0015). A PCT of >= 1.4 ng/mL was associated with NEC versus control (p = 1.4 ng/mL is associated with surgical NEC and may be a potential indicator for risk of disease progression.
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机译：背景：降钙素原 （PCT） 是脓毒症的生物标志物，但尚未研究其在坏死性小肠结肠炎 （NEC） 中的效用。坏死性小肠结肠炎是一种毁灭性的婴儿多系统疾病，在严重的情况下需要手术干预。我们假设 PCT 升高与手术 NEC 相关。患者和方法：在获得机构审查委员会 （IRB） 批准 （#12655） 后，我们在 2010 年至 2021 年期间对 3 个月以下的婴儿进行了一项单一机构回顾性病例对照研究。纳入标准是在 NEC 或脓毒症诊断后 72 小时内抽取 PCT。对照组婴儿在没有感染症状的情况下抽取了PCT。递归分区 （RP） 识别 PCT 截止值。使用 Fisher 精确检验或 chi（2） 检验检验分类变量关联。使用 Wilcoxon 秩和检验、Student t 检验和 Kruskal-Wallis 检验检验连续变量。通过多项式逻辑回归分析获得 PCT 和其他协变量与 NEC 或脓毒症与对照组的校正关联。结果：我们确定了 49 例 NEC 患者、71 例脓毒症患者和 523 例对照患者。根据RP，我们选择了两个PCT临界值：1.4 ng/mL和3.19 ng/ml。与药物（n = 33）NEC相比，PCT为> = 1.4 ng/mL，与药物（n = 33）NEC相关（87.5% vs. 39.4%;p = 0.0015）。与对照组相比，> = 1.4 ng/mL 的 PCT 与 NEC 相关 （p = 1.4 ng/mL 与手术 NEC 相关，可能是疾病进展风险的潜在指标。
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