Serum Procalcitonin Levels in Postoperative Monitoring of Diabetic Patients with Posterior Lumber Vertebral Stabilization Surgery: A Prospective Comparative Study.

Objective: To compare the serum procalcitonin levels and other infection markers released in response to the inflammatory response that develops secondary to the operation in patients with or without type 2 diabetes mellitus who underwent spinal instrumentation.

Methods: Fifty patients, who belonged to the American Society of Anesthesiologist I-II, were between 18 and 65 years of age, and who had planned for posterior spinal instrumentation surgery were grouped into 2 as group I (n = 25) type 2 diabetic patients (group DM) and group II (n=25) non-diabetic patients (group non-DM). On the operation day, preoperatively (T0), 5 minutes after intraoperative instru- ment placement (T1), on postoperative 24th hour (T2), 48th hour (T3), 3rd day (T4), 5th day (T5), 7th day (T6), 10th day (T7), and 15th day (T8), serum samples were obtained from the patients for the evaluation of procalcitonin, C-reactive protein, erythrocyte sedimentation rate, and neutrophil values.

Results: Procalcitonin levels were higher in the diabetic patient group at all time points (P < .01); C-reactive protein levels were higher in T1, T2, and T5 in the diabetic patient group (P < .05). There was no difference in erythrocyte sedimentation rate or neutrophil counts between the groups (P > .05). When the alterations in procalcitonin levels were compared between diabetic and non-diabetic groups, in diabetic patients, there were significantly higher increases in the first 6 timelines (P <.05).

Conclusion: In diabetic patients, the procalcitonin levels were significantly higher at all time points, predicting an augmented bacterial infection in those patients compared with the non-diabetic patients.