title: Relationship between Inflammatory Response and Estimated Complication Rate after Total Hip Arthroplasty.
abstract: BACKGROUND
  After total hip arthroplasty (THA), there is a noteworthy inflammatory response. The inflammatory response is associated with postoperative recovery and complications. However, there had been few reports on the relationship between inflammatory response and postoperative complication rate. The aim of the present study was to investigate early inflammatory response in the first 3 days after THA, and to identify the relationship between inflammatory response and estimated complication rate after surgery.
  
  
  METHODS
  It was a prospective, nonrandomized cohort study. There were 148 patients who underwent unilateral THA in our hospital enrolled. Blood samples were collected preoperatively in the morning of the surgery and at 24, 48, and 72 h after surgery. C-reactive protein (CRP) and interleukin-6 (IL-6) in peripheral blood were measured. The modified physiological and operative severity score for the enumeration of the morbidity (POSSUM) was recorded pre- and intra-operatively. Based on the score, estimated complication rate was calculated. Harris score was used to assess hip function before and after surgery.
  
  
  RESULTS
  IL-6 levels reached the peak at 24 h after surgery and CRP at 48 h. After that, both of the levels decreased. The mean Harris scores significantly increased from 41.62 ± 23.47 before surgery to 72.75 ± 9.13 at 3 days after surgery. The Harris scores after surgery did not have a significant relation with either IL-6 or CRP peak levels (P = 0.165, P = 0.341, respectively). Both CRP and IL-6 peak levels significantly and positively correlated with estimated complication rate after surgery. The estimated complication rate calculated using the POSSUM system was 43 cases of 148 patients. Actually, there were only 28 cases that were observed to get postoperative complications during hospitalization. However, there was no significant difference between estimated and observed complication rates (P = 0.078). In the group with complications, the CRP and IL-6 peak levels were significantly higher than those in the group without complications (both P< 0.001).
  
  
  CONCLUSIONS
  There were significantly positive relationships between both peak levels of CRP and IL-6 and estimated complication rate after THA. Inflammatory response could predict the incidence of complications after THA.
authors: Department of Sports Medicine, Honghui Hospital, Xi'an Jiaotong University Medical College, Xi'an, Shaanxi 710054, China.
authors: Xu-Xu
authors: XX
authors: Chen
authors: Department of Sports Medicine, Honghui Hospital, Xi'an Jiaotong University Medical College, Xi'an, Shaanxi 710054, China.
authors: Tao
authors: T
authors: Wang
authors: Department of Sports Medicine, Honghui Hospital, Xi'an Jiaotong University Medical College, Xi'an, Shaanxi 710054, China.
authors: Jian
authors: J
authors: Li
authors: Department of Sports Medicine, Honghui Hospital, Xi'an Jiaotong University Medical College, Xi'an, Shaanxi 710054, China.
authors: Hui
authors: H
authors: Kang
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein