title: Evaluation of prognostic value of selected biochemical markers in surgically treated patients with acute mediastinitis.
abstract: BACKGROUND
  Monitoring of biochemical markers of inflammation in acute mediastinitis (AM) can be useful in the modification of treatment. This study was a retrospective evaluation of selected biochemical parameters with negative impact on the prognosis in surgically treated patients.
  
  
  METHODS
  There were 44 consecutive patients treated surgically due to AM of differentiated etiology. Selected biochemical markers (WBC, RBC, HGB, HCT, PLT, CRP, PCT, ionogram, protein and albumins) were assessed before surgery and on the 3rd day after surgery. ANOVA was applied to find factors influencing observations. Numerical data [laboratory parameters] were compared by means of medians.
  
  
  RESULTS
  The overall hospital mortality rate was 31.82%. In the group of dead patients, there were observed statistically significant lower mean preoperative values of RBC [p=0.0090], HGB [p=0.0286], HCT [p=0.0354], protein [p= 0.0037], albumins [p=0.0003] and sodium [p<0.0001] and elevated values of CRP [P=0.0107] and PCT p<0.0001]. High level of inflammatory markers on day 3 after surgery was found to increase the risk of death - for WBC (by 67%), for CRP (by 88%) and for PCT (by 100%).
  
  
  CONCLUSIONS
  Poor prognosis was more frequent in patients with preoperative high levels of CRP, PCT, anemia, hypoproteinemia and hyponatremia. The risk of death increases significantly if in the immediate postoperative period no distinct decrease in WBC count and of the CRP and PCT level is observed. In such a situation the patients should be qualified earlier for broadened diagnostic workup and for reoperation.
authors.affiliation: Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Lodz, Lodz, Poland. jablonski_s@vp.pl
authors.forename: Sławomir
authors.initials: S
authors.lastname: Jabłoński
authors.forename: Marian
authors.initials: M
authors.lastname: Brocki
authors.forename: Kujawski
authors.initials: K
authors.lastname: Krzysztof
authors.forename: Marcin
authors.initials: M
authors.lastname: Wawrzycki
authors.forename: Edyta
authors.initials: E
authors.lastname: Santorek-Strumiłło
authors.forename: Marek
authors.initials: M
authors.lastname: Łobos
authors.forename: Marcin
authors.initials: M
authors.lastname: Kozakiewicz
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008480:Mediastinitis / Q000097:blood* / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators