Hypothesis: Infections and sepsis are major complications in secondary peritonitis and still represent a diagnostic challenge. We hypothesized that the laboratory marker procalcitonin would provide an early and reliable assessment of septic complications. Design: Prospective, international, multicenter inception cohort study. Setting: Five European surgical referral centers. Patients: Eighty-two patients with intraoperatively proven secondary peritonitis were enrolled within 96 hours of symptom

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... onset. Main Outcome Measures: Procalcitonin and the laboratory routine marker C-reactive protein (CRP) were prospectively assessed and monitored for a maximum of 21 consecutive days. Results: Procalcitonin concentrations were most closely correlated with the development of septic multiorgan dysfunction syndrome (MODS), with peak levels occurring