title: Systemic inflammatory response syndrome and surgical stress in thoracic surgery.
abstract: OBJECTIVE
  To evaluate the clinical usefulness of postoperative systemic inflammatory response syndrome (SIRS) as an index of surgical stress in patients undergoing thoracic surgery.
  
  
  METHODS
  Forty-five consecutive patients who underwent thoracic surgery with thoracotomy were enrolled. The SIRS criteria were examined daily during the first 7 postoperative days. The serum interleukin-6 (IL-6) level, operation time, intraoperative blood loss, amount of thoracic drainage, and C-reactive protein levels were also measured.
  
  
  RESULTS
  Sixteen cases were categorized into the SIRS group, whereas 29 cases were categorized into the non-SIRS group. Among the patients who underwent thoracic surgery, the physiological responses of the patients to the surgery, such as serum IL-6 levels and C-reactive protein levels, were significantly higher in the SIRS group than in the non-SIRS group (P = .002 and .024, respectively). The serum IL-6 level on the first postoperative day was an independent factor associated with SIRS (95% CI 1.002-1.041; P = .030). Furthermore, there was a correlation between the number of SIRS days and the duration of the postoperative hospital stay (r = 0.379, P = .012).
  
  
  CONCLUSIONS
  Our results demonstrated that SIRS reflected the degree of surgical stress, especially thoracotomic procedures, through the IL-6 levels, and affected the postoperative hospital stay. Systemic inflammatory response syndrome can be useful for the postoperative management of patients undergoing thoracic surgery.
authors.affiliation: Department of Thoracic Surgery, Kishiwada City Hospital, Kishiwada 596-8501, Japan. katake@kuhp.kyoto-u.ac.jp
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Takenaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Ogawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Wada
authors.forename: Toshiki
authors.initials: T
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011184:Postoperative Period; D012121:Respiration, Artificial; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000503:physiopathology*; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology*; D019616:Thoracic Surgical Procedures
chemical_list: D016207:Cytokines