Measurement of Serum Procalcitonin as an Early Predictor of Post-operative Complications after Elective Liver Resection

Background: Accurate and early detection of postoperative complications after elective liver resection (LR) remains a challenge. A reliable predictor is essential for guiding therapy and improving outcomes. This study aimed to evaluate the role of serum procalcitonin (PCT) in predicting postoperative complications after LR. Methods: This prospective observational study was conducted at BSMMU, Dhaka, from July 2021 to June 2024. A total of 84 patients undergoing elective LR were included. Informed consent was obtained before surgery. Serum PCT levels were measured on postoperative days (POD) 1, 3, and 7 using the Siemens Atellica IM BRAHMS PCT analyzer. Other markers, including WBC count, CRP, and liver and renal function tests, were also recorded. Patients were categorized into two groups: those without complications (group 1, n=20) and those with complications (group 2, n=22). Statistical analyses were conducted using SPSS 25.0, with a significance level of P<0.05. Results: Postoperative complications occurred in 52.4% of patients. Mean serum PCT levels were significantly higher in group 2 than in group 1 on POD 1 (0.898 ± 0.787 vs. 2.508 ± 2.587 µg/L, P=0.011), POD 3 (0.314 ± 0.249 vs. 0.890 ± 0.735 µg/L, P=0.002), and POD 7 (0.181 ± 0.217 vs. 0.611 ± 0.610 µg/L, P=0.005). WBC count and CRP levels did not show statistical significance. ROC analysis identified a PCT cutoff of 1.100 µg/L on POD 1, with sensitivity 86.4%, specificity 70.0%, PPV 74.2%, and NPV 83.7%. Conclusion: Serum PCT on POD 1 is a strong early predictor of complications after elective LR. A cutoff value of 1.100 µg/L accurately predicts morbidities, regardless of the type of disease or surgical procedure.