title: Preoperative adipocytokines as a predictor of surgical infection after colorectal surgery: a prospective survey.
abstract: BACKGROUND
  Infections are the leading cause of morbidity and mortality after colorectal surgery. Obesity is a well-known risk factor for wound infection, but it does not seem to increase the risk of other infectious complications. The aim of this study was to look for a relationship between the fatty tissue metabolism measured by adipocytokine levels and the risk of postoperative infection.
  
  
  METHODS
  Preoperative plasma levels of eight adipocytokines, cholesterol, triglycerides, insulin and C-reactive protein (CRP) were measured in consecutive patients undergoing elective colorectal surgery between June 2008 and June 2011. Information about epidemiological and clinical characteristics was obtained for each patient. All infections in the 30 days following surgery were recorded.
  
  
  RESULTS
  Among the 174 patients included, 49 (28 %) presented with a postoperative infection: 41 surgical site infections and 8 other infections. Preoperative leptin, insulin and CRP were significantly higher in patients with postoperative infection (p = 0.025, p = 0.020 and p = 0.044, respectively), but only leptin was predictive of infection in multivariate analysis (odds ratio (OR) = 1.89, 95 % confidence interval (CI) 1.18-3.03, p = 0.008). The predictive value of leptin was slightly lower for surgical site infection (OR = 1.65, 95 % CI 1.06-2.55, p = 0.025). Leptin levels were independent of the other adipocytokine levels but not of the body mass index.
  
  
  CONCLUSIONS
  Although markers of inflammation and insulin resistance are also related to the onset of surgical infection, leptin correlates more closely with the risk of infection than does any other factor. However, its effect could be partially mediated by the body mass index.
authors.affiliation: Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France, pablo.ortega-deballon@chu-dijon.fr.
authors.forename: Pablo
authors.initials: P
authors.lastname: Ortega-Deballon
authors.forename: Laurence
authors.initials: L
authors.lastname: Duvillard
authors.forename: Marie-Lorraine
authors.initials: ML
authors.lastname: Scherrer
authors.forename: Sophie
authors.initials: S
authors.lastname: Deguelte-Lardière
authors.forename: Abderrahmanne
authors.initials: A
authors.lastname: Bourredjem
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Petit
authors.forename: Claire
authors.initials: C
authors.lastname: Bonithon-Kopp
mesh_terms: D054392:Adipokines / Q000097:blood*; D000368:Aged; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000097:blood* / Q000209:etiology*
chemical_list: D054392:Adipokines