Alarmins and Clinical Outcomes After Major Abdominal Surgery-A Prospective Study.
OBJECTIVE
Tissue injury causing immune response is an integral part of surgical procedure. Evaluation of the degree of surgical trauma could help to improve postoperative management and determine the clinical outcomes.


METHODS
We analyzed serum levels of alarmins, including S100A5, S100A6, S100A8, S100A9, S100A11, and S100A12; high-mobility group box 1; and heat-shock protein 70, after elective major abdominal surgery (n = 82). Blood samples were collected for three consecutive days after surgery. The goals were to evaluate the relationships among the serum levels of alarmins and selected surgical characteristics and to test potential of alarmins to predict the clinical outcomes.


RESULTS
Significant, positive correlations were found for high-mobility group box 1 with the length of surgery, blood loss, and intraoperative fluid intake for all three days of blood sampling. The protein S100A8 serum levels showed positive correlations with intensive care unit length of stay, 28-day and in-hospital mortality. The protein S100A12 serum levels had significant, positive correlations with intensive care unit length of stay, 28-day mortality, and in-hospital mortality. We did not find significant differences in alarmin levels between cancer and noncancer subjects.


CONCLUSIONS
The high-mobility group box 1 serum levels reflect the degree of surgical injury, whereas proteins S100A8 and S100A12 might be considered good predictors of major abdominal surgery morbidity and mortality.
a University of Ostrava , Ostrava , Czech Republic.|b University Hospital of Ostrava , Ostrava , Czech Republic.
Jan
J
Máca
a University of Ostrava , Ostrava , Czech Republic.|b University Hospital of Ostrava , Ostrava , Czech Republic.
Filip
F
Burša
a University of Ostrava , Ostrava , Czech Republic.|b University Hospital of Ostrava , Ostrava , Czech Republic.
Pavel
P
Ševčík
a University of Ostrava , Ostrava , Czech Republic.|b University Hospital of Ostrava , Ostrava , Czech Republic.
Peter
P
Sklienka
c University of Ostrava , Institute for Research and Applications of Fuzzy Modeling , Ostrava , Czech Republic.
Michal
M
Burda
d Univerzita Karlova v Praze , First Faculty Of Medicine , Praha , Czech Republic.|e Military Hospital of Prague , Prague , Czech Republic.
Michal
M
Holub
D000005:Abdomen / Q000601:surgery; D000368:Aged; D000067531:Alarmins / Q000097:blood*; D018153:Czech Republic / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000601:surgery; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*
D000067531:Alarmins; D024243:HMGB1 Protein; C585491:HMGB1 protein, human; D018840:HSP70 Heat-Shock Proteins; D009418:S100 Proteins; C110294:S100A1 protein
alarmins; damage-associated molecular patterns; gastrointestinal resection; major abdominal surgery; outcome; surgical injury