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Association between preoperative acute phase response and postoperative complications
W Haupt1, W Hohenberger, R Mueller
1Department of Surgery, University Hospital, Erlangen, Germany.
The European Journal of Surgery = Acta Chirurgica
|January 1, 1997
Summary
Preoperative acute phase response, indicated by elevated inflammatory markers like C-reactive protein (CRP), is linked to increased postoperative infective complications. Early detection of this response can help predict patient outcomes after major surgery.
Area of Science:
- Surgical oncology
- Immunology
- Clinical pathology
Background:
- The acute phase response (APR) is a systemic reaction to tissue injury or inflammation.
- Elevated APR markers preoperatively may indicate a patient's susceptibility to postoperative complications.
Purpose of the Study:
- To investigate the association between preoperative acute phase response and the incidence of postoperative infective complications.
Main Methods:
- Prospective study involving 229 patients undergoing major abdominal surgery.
- Serum levels of interleukin-6 (IL-6), alpha-1-antitrypsin, C-reactive protein (CRP), albumin, and prealbumin were measured preoperatively.
- Abnormal values of these markers were assessed for correlation with outcomes.
Main Results:
- 11% of patients experienced major complications, with a 4% mortality rate.
- A significant association was found between elevated preoperative APR markers (IL-6, alpha-1-antitrypsin, CRP) and the development of postoperative infective complications (p < 0.001).
- Patients with signs of increased preoperative APR were more likely to develop severe systemic inflammatory responses due to infection.
Conclusions:
- Preoperative acute phase response is a significant predictor of adverse outcomes, including infective complications, following major abdominal surgery.
- Elevated APR markers suggest a higher risk of poor response to surgery and postoperative infection.