title: Inflammation and outcome after general thoracic surgery.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University, New York, NY 10021, United States. amard@mskcc.org
authors.forename: David
authors.initials: D
authors.lastname: Amar
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Bernard
authors.initials: B
authors.lastname: Park
authors.forename: Paul M
authors.initials: PM
authors.lastname: Heerdt
authors.forename: Martin
authors.initials: M
authors.lastname: Fleisher
authors.forename: Howard T
authors.initials: HT
authors.lastname: Thaler
mesh_terms: D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D012709:Serum Albumin; D002097:C-Reactive Protein