[Assessment of specific indicators for determining postoperative infectious complications]

The acute-phase proteins CRP, haptoglobin, and sialic acid of 312 surgical patients (159 females and 153 males), aged between 18 and 95 years, were examined with a view to finding parameters for early prediction of perioperative septic complications. Laboratory tests were additionally applied to 39 patients for activated lymphocytes as well as for OKT3-, OKT4-, and OKT8-labelled T-lymphocytes. Straight forward postoperative decline in absolute numbers of OKT3- and OKT4-labelled T-lymphocytes was recordable from patients with septic complications, in contrast to patients with uneventful clinical courses. However, the OKT4 and OKT8 ratio did not yield any correlation with the clinical course. In acute-phase protein testing, a correlation was found to exist between CRP and clinical course. CRP levels in patients without septic complications (Group I) were found to depend clearly on the anatomic site of surgery. Normalisation of CRP levels was recordable from patients with primary septic disease and complete surgical management of the focus (Group II/1). Postoperative decline of CRP values was much less in patients with primary septic disease and incomplete surgical treatment (Group II/2). They had not even reached normality towards the end of observation. On average, unambiguously increased values were recordable as early as three days prior to clinical manifestation from patients with postoperative septic complications (Group III). Septic complications were found to occur along with re-increase or delayed decrease of CRP levels, after the fourth postoperative day. Sensitivity amounted to 78 per cent and specificity to 89 per cent.