Inflammation and outcome after general thoracic surgery
Inflammation and outcome after general thoracic surgery
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DOI：
10.1016/j.ejcts.2007.06.017
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发表时间：
2007-09-01
影响因子：
3.4
通讯作者：
Thaler, Howard T.
中科院分区：
文献类型：
--
作者：
Amar, David;Zhang, Hao;Thaler, Howard T.
目的：确定术前炎症是否易导致主要术后并发症（PC）和不良结局。方法：前瞻性收集153例年龄73 - 6岁的连续患者的资料，计划在三级癌症中心进行肺切除术。在术前、到达麻醉后监护室时和术后第一天早晨测量高敏C反应蛋白（CRP）和白细胞介素（IL）-6水平。结果：153例患者中9例（5.9%）发生PC。与无PC的患者相比，有PC的患者有更高的高血压史（P = 0.047），更高的非甾体抗炎药使用频率（P = 0.007），术前白蛋白水平较低，3.75 +/- 0.65 g/dl vs 4.28 +/- 0.33 g/dl，P = 0.03。受试者操作特征分析表明PC与术前CRP（曲线下面积为0.86）、白蛋白（曲线下面积为0.86）之间存在强相关性，而与IL-6（曲线下面积为0.79）之间的相关性较低。结论：炎症标志物CRP和IL-6可以帮助区分主要PC的高风险患者。这些初步和新的数据表明，除了两个白蛋白，以前描述的结果的标志物，全身炎症可能是重要的PC的发病机制中的重要。(c)2007年欧洲胸外科协会。Elsevier B. V.出版，保留所有权利。
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 tow albumin, a previously described marker of outcome, systemic inflammation is likely to be important in the pathogenesis of important PC. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.