Inflammation and outcome after general thoracic surgery.

TitleInflammation and outcome after general thoracic surgery.
Publication TypeJournal Article
Year of Publication2007
AuthorsAmar D, Zhang H, Park B, Heerdt PM, Fleisher M, Thaler HT
JournalEur J Cardiothorac Surg
Date Published2007 Sep
KeywordsAged, Biological Markers, C-Reactive Protein, Female, Humans, Inflammation, Inflammation Mediators, Interleukin-6, Male, Postoperative Complications, Predictive Value of Tests, Prognosis, Serum Albumin, Thoracic Surgical Procedures

OBJECTIVE: To determine whether preoperative inflammation predisposes to major postoperative complications (PC) and poor outcome.

METHODS: Prospective data collection of 153 consecutive patients aged 73+/-6 years scheduled for lung resection at a tertiary cancer center. High sensitivity C-reactive protein (CRP) and interleukin (IL)-6 levels were measured before surgery, on arrival to the postanesthesia care unit, and on the first morning after surgery.

RESULTS: PC occurred in 9/153 (5.9%) patients. In comparison to patients without PC, those with PC had a greater history of hypertension (P=0.047), higher frequency of non-steroidal anti-inflammatory drug use (P=0.007) and had a lower preoperative albumin level, 3.75+/-0.65 g/dl versus 4.28+/-0.33 g/dl, P=0.03. Receiver operating characteristic analysis demonstrated a strong association between PC and preoperative CRP (area under the curve of 0.86), albumin (area under the curve of 0.86) and less so for IL-6 (area under the curve of 0.79).

CONCLUSIONS: Markers of inflammation, CRP and IL-6, can help distinguish patients who are at high risk for major PC. These preliminary and novel data suggest that in addition to low albumin, a previously described marker of outcome, systemic inflammation is likely to be important in the pathogenesis of important PC.

Alternate JournalEur J Cardiothorac Surg
PubMed ID17643996