Association between preoperative acute phase response and postoperative complications.
OBJECTIVE
To find out if there is an association between the acute phase response preoperatively and the development of postoperative infective complications.


METHODS
Prospective open study.


METHODS
Teaching hospital Germany.


METHODS
229 patients who were to undergo major abdominal operations.


METHODS
Measurements of serum concentrations of interleukin 6 (IL-6), alpha-1-antitrypsin, C-reactive protein (CRP), albumin, and prealbumin.


METHODS
Abnormal values of substances measured.


RESULTS
Serum concentrations of IL-6, alpha-1-antitrypsin and CRP were raised, and those of albumin and prealbumin were reduced in 5% to 14% of patients. 25 (11%) developed major complications, of whom 9 (4%) died. 9 Patients (4%) had a severe systemic inflammatory response caused by infective complications that did not result from technical failure of the operative technique. Of these 9 patients, 7 (78%) already had signs of an increased acute phase response before operation that was significantly different from the incidence among patients who recovered without complications (21/204. p < 0.001)


CONCLUSIONS
These data suggest that if there are signs of an acute phase response preoperatively the patient's response to operation and infection during the postoperative period may be adversely affected.
Haupt
W
W
Department of Surgery, University Hospital, Erlangen, Germany.
Hohenberger
W
W
Mueller
R
R
Klein
P
P
Christou
N V
NV
D000210:Acute-Phase Reaction / Q000150:complications* / Q000276:immunology; D002097:C-Reactive Protein / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000276:immunology*; D015850:Interleukin-6 / Q000097:blood; D011183:Postoperative Complications / Q000276:immunology*; D011228:Prealbumin / Q000378:metabolism; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D000515:alpha 1-Antitrypsin / Q000378:metabolism
D015850:Interleukin-6; D011228:Prealbumin; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein