ArticleBJA open2026
Procalcitonin and interleukin-6 to diagnose infection in cardiac surgery patients with hyperinflammation: a two-centre, prospective cross-sectional study.
Article in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05199025 (Biomarkers to Guide Perioperative Management and Improve Outcome in High-risk Surgery), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Biomarkers to Guide Perioperative Management and Improve Outcome in High-risk Surgery
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10 authors.
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Abstract
Background: Inflammation after cardiac surgery complicates infection diagnosis. The diagnostic value of procalcitonin (PCT) in patients with suspected infection remains unclear. We studied the diagnostic performance of PCT in elective cardiac surgery patients suspected of early-onset infection. Secondarily, we analysed C-reactive protein (CRP), leucocytes, interleukin-6 (IL-6), and neutrophil/lymphocyte ratio (NLR). Methods: A two-centre, prospective study was conducted. Patients were suspected of infection if they developed abnormal body temperature (<36.0°C or >38.0°C), had blood cultures drawn, or received antibiotic treatment within the first 3 postoperative days. A positive and negative diagnostic threshold was assessed at the time infection was suspected, with a negative likelihood ratio (-LR) <0.2 and a positive likelihood ratio (+LR) >5 deemed clinically relevant for ruling out and ruling in infection, respectively. Results: Infection was confirmed in 21/284 (7%) patients. The area under the curve (AUC) for PCT was 0.59 (95% confidence interval [CI] 0.47-0.71). No PCT threshold met predefined clinical relevance criteria, with a minimum -LR of 0.25 at 0.15 μg L Conclusions: PCT did not meet clinically important thresholds, offering no valuable diagnostic information in patients with suspected infection early after cardiac surgery, whereas IL-6 did. IL-6 appears promising for ruling out infection, warranting further investigation. Trial registration number: clinicaltrials.gov, registration number NCT05199025, Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/6DGJS.
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