Clinical impact of interleukin 6 as a predictive biomarker in the early diagnosis of postoperative systemic inflammatory response syndrome after major thoracic surgery: A prospective clinical trial

被引:41
作者
Fink-Neuboeck, Nicole [1 ]
Lindenmann, Joerg [1 ]
Bajric, Sedin [1 ]
Maier, Alfred [1 ]
Riedl, Regina [2 ]
Weinberg, Annelie Martina [3 ]
Smolle-Juettner, Freyja Maria [1 ]
机构
[1] Med Univ Graz, Div Thorac & Hyperbar Surg, Auenbrugger Pl 29, A-8036 Graz, Austria
[2] Med Univ Graz, Inst Med Informat Stat & Documentat, Graz, Austria
[3] Med Univ Graz, Dept Orthoped & Orthoped Surg, Graz, Austria
关键词
INTENSIVE-CARE-UNIT; C-REACTIVE PROTEIN; CYTOKINE LEVELS; SEPTIC SHOCK; SEPSIS; PROCALCITONIN; ESOPHAGECTOMY; MARKERS; FAILURE; CANCER;
D O I
10.1016/j.surg.2016.04.004
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Postoperative systemic inflammatory response syndrome and sepsis are associated with high morbidity and mortality rates. Early detection of postoperative systemic inflammatory response syndrome improves the outcome. The aim of this study was to evaluate the feasibility of interleukin 6 as a predictive biomarker in the early diagnosis of postoperative systemic inflammatory response syndrome after a major thoracic operation. Methods. A total of 94 patients were enrolled in this prospective, clinical, single-center study. The enrolled subjects underwent either lung resection or esophageal operation. Interleukin 6, procalcitonin, C-reactive protein, and leucocytes were measured sequentially before, during, and after the operation. These levels were compared between patients who developed postoperative systemic inflammatory response syndrome and those who did not. Results. The enrollees who completed the study included of 55 males (79.7 %) and 14 females (20.3 %) with a mean age of 60.9 years. Twenty patients (29.0%) developed systemic inflammatory response syndrome at a median time of 33.0 hours postoperatively. In cases of postoperative systemic inflammatory response syndrome, interleukin 6 was the most predictive biomarker, showing a striking increase on the day of operation and preceding the median onset of postoperative systemic inflammatory response syndrome, which occurred the next day (P <= .001). Peak procalcitonin and C-reactive protein occurrence were significantly delayed at 24 hours (P =.012) and 48 hours (P =.012). There was no mortality 30 days postoperatively. Conclusion. Interleukin 6 is a reliable predictor of postoperative systemic inflammatory response syndrome, and it is able to detect postoperative system inflammatory response syndrome before the onset of related clinical symptoms. When identifying patients at high risk, it would be beneficial to include interleukin 6 in conventional postoperative monitoring, particularly after extended surgical resection.
引用
收藏
页码:443 / 453
页数:11
相关论文
共 25 条
[1]   Interleukin-6 production in lung tissue after transthoracic esophagectomy [J].
Abe, T ;
Oka, M ;
Tangoku, A ;
Hayashi, H ;
Yamamoto, K ;
Yahara, N ;
Morita, K ;
Tabata, T ;
Ohmoto, Y .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2001, 192 (03) :322-329
[2]   Influence of systemic inflammatory response syndrome and sepsis on outcome of critically ill infected patients [J].
Alberti, C ;
Brun-Buisson, C ;
Goodman, SV ;
Guidici, D ;
Granton, J ;
Moreno, R ;
Smithies, M ;
Thomas, O ;
Artigas, A ;
Le Gall, JR .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2003, 168 (01) :77-84
[3]   Inflammation and outcome after general thoracic surgery [J].
Amar, David ;
Zhang, Hao ;
Park, Bernard ;
Heerdt, Paul M. ;
Fleisher, Martin ;
Thaler, Howard T. .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2007, 32 (03) :431-434
[4]   Activation of monocytes and endothelial cells depends on the severity of surgical stress [J].
Aosasa, S ;
Ono, S ;
Mochizuki, H ;
Tsujimoto, H ;
Osada, S ;
Takayama, E ;
Seki, S ;
Hiraide, H .
WORLD JOURNAL OF SURGERY, 2000, 24 (01) :10-16
[5]   Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit [J].
Balci, C ;
Sungurtekin, H ;
Gürses, E ;
Sungurtekin, U ;
Kaptanoglu, B .
CRITICAL CARE, 2003, 7 (01) :85-90
[6]   AMERICAN-COLLEGE OF CHEST PHYSICIANS SOCIETY OF CRITICAL CARE MEDICINE CONSENSUS CONFERENCE - DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ ;
ABRAMS, JH ;
BERNARD, GR ;
BIONDI, JW ;
CALVIN, JE ;
DEMLING, R ;
FAHEY, PJ ;
FISHER, CJ ;
FRANKLIN, C ;
GORELICK, KJ ;
KELLEY, MA ;
MAKI, DG ;
MARSHALL, JC ;
MERRILL, WW ;
PRIBBLE, JP ;
RACKOW, EC ;
RODELL, TC ;
SHEAGREN, JN ;
SILVER, M ;
SPRUNG, CL ;
STRAUBE, RC ;
TOBIN, MJ ;
TRENHOLME, GM ;
WAGNER, DP ;
WEBB, CD ;
WHERRY, JC ;
WIEDEMANN, HP ;
WORTEL, CH .
CRITICAL CARE MEDICINE, 1992, 20 (06) :864-874
[8]   An early inflammatory response to oesophagectomy predicts the occurrence of pulmonary complications [J].
D'Journo, Xavier Benoit ;
Michelet, Pierre ;
Marin, Valerie ;
Diesnis, Isabelle ;
Blayac, Dorothee ;
Doddoli, Christophe ;
Bongrand, Pierre ;
Thomas, Pascal Alexandre .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2010, 37 (05) :1144-1151
[9]   The relationship between intraoperative blood transfusion and postoperative systemic inflammatory response syndrome [J].
Ferraris, Victor A. ;
Ballert, Erik Q. ;
Mahan, Angela .
AMERICAN JOURNAL OF SURGERY, 2013, 205 (04) :457-465
[10]   Prognostic value of interleukin 6, procalcitonin, and C-reactive protein levels in intensive care unit patients during first increase of fever [J].
Fraunberger, P ;
Wang, Y ;
Holler, E ;
Parhofer, KG ;
Nagel, D ;
Walli, AK ;
Seidel, D .
SHOCK, 2006, 26 (01) :10-12