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Interleukin-6 and Hospital Length of Stay after Open-heart Surgery
Amy L Ai1, Daniel Hall2, Steven F Bolling3
1Florida State University, Florida, USA.
Insights
Postoperative Interleukin-6 (IL-6) levels, along with age and perfusion time, significantly predict length of hospitalization (LOH) after open-heart surgery. This finding reinforces the role of IL-6 in patient recovery post-cardiac procedures.
Area of Science:
- Cardiology
- Immunology
- Surgical Outcomes
Background:
- Elevated Interleukin-6 (IL-6), a pro-inflammatory cytokine, is common in heart disease.
- IL-6 may contribute to systemic inflammatory response syndrome (SIRS) after cardiopulmonary bypass (CPB) during open-heart surgery.
- Previous research utilized non-laboratory data to predict length of hospitalization (LOH) post-open-heart surgery.
Purpose of the Study:
- To investigate the association between postoperative plasma IL-6 levels and LOH in patients undergoing open-heart surgery.
- To build upon prior findings by incorporating IL-6 as a potential predictor of LOH.
Main Methods:
- Patients undergoing cardiac surgery (CABG, valve repair/replacement) requiring CPB were enrolled.
- Postoperative plasma IL-6 was measured using a high-sensitivity enzyme immunoassay kit.
- Cardiac indices were sourced from the Society of Thoracic Surgeons' (STS) Adult Cardiac Database.
Main Results:
- Univariate analysis identified older age, comorbidities, perfusion time, and postoperative IL-6 as significant correlates of LOH.
- Regression analysis confirmed that age, perfusion time, and postoperative IL-6 were significant predictors of LOH (p<.01).
- The regression model explained 28.2% of the variance in LOH (R²=.282).
Conclusions:
- The study confirms the link between postoperative IL-6 and perfusion time with LOH.
- Postoperative plasma IL-6 is demonstrated as a significant predictor of LOH following open-heart surgery.
Background:
Interleukin-6 (IL-6) is a multi-function, pro-inflammatory cytokine that is chronically elevated in heart diseases. Research suggested that IL-6 may play an important role in the development of systemic inflammatory response syndrome (SIRS) following cardiopulmonary bypass (CPB) used in major open-heart surgery. The present study capitalized on a previous report that used non-laboratory preoperative data of 235 patients undergoing open-heart surgery to predict their length of hospitalization (LOH) following open-heart surgery.
Methods:
All patients underwent cardiac surgery (e.g., CABG, valve repair or valve replacement surgery), requiring CPB. Two weeks prior to their scheduled operation, trained research assistants blinded to cardiac indices and laboratory data recruited patients for a psychosocial study and conducted interviews. Key cardiac indices were obtained from a national database: the Society of Thoracic Surgeons' (STS) Adult Cardiac Database at the hospital. Blood samples were collected three days postoperatively for biomarker assays. Plasma was stored within 30 minutes of acquisition. Plasma IL-6 was measured using a sandwich enzyme immunoassay kit, Quantikine High-Sensitivity IL-6 (R&D Systems, Minneapolis MN) with no modification of the manufacturer protocol.
Results:
Univariate analysis shows that significantly correlated with LOH were older age, more medical comorbidities, perfusion time and postoperative IL-6. Results from the regression model predicting LOH [F (10, N=215)=8.042, p<.001, R2=.282], showed that, among known predictors in the previous report and other STS cardiac indices, only age, perfusion time and postoperative IL-6 were significantly associated with LOH (p<.01).
Conclusion:
Besides the replication of the previous finding in linking postoperative IL-6 and perfusion time, the study demonstrated the link between postoperative plasma IL-6 and LOH.
