title: The use of inflammatory markers as a method for discharging patients post hip or knee arthroplasty.
abstract: BACKGROUND
  Complications after orthopaedic surgery have a substantial impact on resources, including the financial resources of the health-care system. Early detection of patients developing complications, thus excluding those patients without complications should have a major impact on patients' management.
  
  
  METHODS
  We evaluated the prognostic value of blood levels of inflammatory markers (interleukin-6, C-reactive protein, total white blood cell count) for complications after primary hip and knee arthroplasty in a routine setting, and their impact on patient management. First, the three inflammatory markers were evaluated in 68 consecutive patients treated at the Department of Orthopaedics. Laboratory markers were measured on days 2 and 4 after surgery. Second, patient management before and after adapting the routine order for laboratory parameters after arthroplasty were evaluated.
  
  
  RESULTS
  We could show that interleukin-6 and the C-reactive protein had an almost equal negative predictive value for the exclusion of postsurgical complications. Nevertheless, interleukin-6 returned below its reference levels almost 2 days earlier compared to the other markers. This made an earlier discharge of patients with presumable complications-less postsurgical process possible.
  
  
  CONCLUSIONS
  So, the total number of patients treated as well as the financial reimbursement could be increased and concurrently occupancy days and averaged length of stay were reduced.
authors.affiliation: Department of Orthopaedics, General Hospital Steyr, Steyr, Austria.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Koppensteiner
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Auersperg
authors.forename: Gabriele
authors.initials: G
authors.lastname: Halwachs-Baumann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000737:chemistry; D005260:Female; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein