Postoperative Interleukin-6 Level and Early Detection of Complications After Elective Major Abdominal Surgery.
Ann Surg
; 263(6): 1207-12, 2016 06.
Article
en En
| MEDLINE
| ID: mdl-26135695
ABSTRACT
OBJECTIVE:
To assess the association of systemic inflammation and outcome after major abdominal surgery.BACKGROUND:
Major abdominal surgery carries a high postoperative morbidity and mortality rate. Studies suggest that inflammation is associated with unfavorable outcome.METHODS:
Levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α and the systemic inflammatory response syndrome (SIRS) were assessed in 137 patients undergoing major abdominal surgery. Blood samples were drawn on days 0, 1, 3, and 7, and SIRS was scored during 48âhours after surgery. Primary outcome was a composite of mortality, pneumonia, sepsis, anastomotic dehiscence, wound infection, noncardiac respiratory failure, atrial fibrillation, congestive heart failure, myocardial infarction, and reoperation within 30 days of surgery.RESULTS:
An IL-6 level more than 432âpg/mL on day 1 was associated with an increased risk of complications (adjusted odds ratio 3.3; 95% confidence interval [CI] 1.3-8.5) and a longer median length of hospital stay (7 vs 12 days, P < 0.001). As a single test, an IL-6 cut-off level of 432âpg/mL on day 1 yielded a specificity of 70% and a sensitivity of 64% for the prediction of complications (area under the curve 0.67; 95% CI 0.56-0.77). Levels of CRP started to discriminate from day 3 onward with a specificity of 87% and a sensitivity of 58% for a cut-off level of 203 mg/L (AUC 0.73; 95% CI 0.63-0.83).CONCLUSIONS:
A high IL-6 level on day 1 is associated with postoperative complications. Levels of IL-6 help distinguish between patients at low and high risk for complications before changes in levels of CRP.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Complicaciones Posoperatorias
/
Interleucina-6
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Síndrome de Respuesta Inflamatoria Sistémica
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Abdomen
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Ann Surg
Año:
2016
Tipo del documento:
Article
País de afiliación:
Países Bajos