Dependability of Procalcitonin as an Early Predictor of Infection in Open Fractures: An Observational Study

Cureus. 2024 Dec 17;16(12):e75892. doi: 10.7759/cureus.75892. eCollection 2024 Dec.

Abstract

Introduction Open extremity fractures are complex injuries involving soft tissue disruption and bone discontinuity, often associated with significant morbidity and mortality due to complications such as infection. Infection remains a primary concern, exacerbating patient outcomes and increasing healthcare costs. Procalcitonin (PCT) is a biomarker with potential utility for early detection of infection in these cases. Materials and methods This prospective observational study was conducted at Justice K S Hegde Charitable Hospital between October 2022 and April 2024. Forty patients with open fractures who met inclusion criteria were enrolled. PCT levels were measured preoperatively and on postoperative days 1 and 5. Patients were monitored for clinical signs of infection for one month. Data analysis included descriptive and inferential statistics. Results The mean age of the patients was 42.26 ± 16.62 years, with a male predominance of 35 (87.5%) of the total sample size. Preoperative PCT levels were significantly higher in patients who developed infections (mean: 1.02 ng/mL) compared to non-infected patients (mean: 0.13 ng/mL). Postoperative PCT levels continued to rise in all patients but were significantly elevated in the infected group (p < 0.01). Conclusion PCT is a reliable biomarker for the early detection of postoperative infections in open fractures. Elevated preoperative PCT levels (>0.5 ng/mL) predict infection, while non-infected patients showed lower trauma-related increases. Further studies with larger samples are recommended to validate these findings.

Keywords: infection prediction; open fractures; orthopedic trauma; postoperative infection; procalcitonin (pct).