Inflammation and outcome after general thoracic surgery.
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.
Amar
David
D
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
Zhang
Hao
H
Park
Bernard
B
Heerdt
Paul M
PM
Fleisher
Martin
M
Thaler
Howard T
HT
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*
D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D012709:Serum Albumin; D002097:C-Reactive Protein