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Inflammation and outcome after general thoracic surgery.
David Amar1, Hao Zhang, Bernard Park
1Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University, New York, NY 10021, United States. amard@mskcc.org
Summary
Preoperative inflammation markers, C-reactive protein (CRP) and interleukin-6 (IL-6), predict major postoperative complications (PC) in lung resection patients. Systemic inflammation, alongside low albumin, is crucial in PC development.
Area of Science:
- Medical research
- Surgical oncology
- Inflammation markers
Background:
- Postoperative complications (PC) significantly impact patient outcomes after lung resection.
- Identifying preoperative predictors of PC is crucial for risk stratification and management.
Purpose of the Study:
- To investigate whether preoperative inflammation predisposes patients to major postoperative complications (PC) and poor outcomes following lung resection.
Main Methods:
- Prospective data collection from 153 patients undergoing lung resection.
- Measurement of high-sensitivity C-reactive protein (CRP) and interleukin-6 (IL-6) preoperatively and postoperatively.
- Analysis of patient history, medication use, and preoperative albumin levels.
Main Results:
- 5.9% of patients experienced major PC.
- Patients with PC had higher rates of hypertension and NSAID use, and lower preoperative albumin levels.
- Receiver operating characteristic analysis showed strong associations between PC and preoperative CRP (AUC 0.86) and albumin (AUC 0.86).
Conclusions:
- Preoperative CRP and IL-6 levels can identify patients at high risk for major PC.
- Systemic inflammation, indicated by CRP and IL-6, plays a significant role in the pathogenesis of major PC.
- These findings highlight the importance of assessing inflammation markers in addition to albumin for predicting outcomes in lung surgery.
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