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Interleukin-6 as a critical inflammatory marker for early diagnosis of surgical site infection after spine surgery

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Titel: Interleukin-6 as a critical inflammatory marker for early diagnosis of surgical site infection after spine surgery
Autoren: Roch, Paul Jonathan, Ecker, Carolin, Jäckle, Katharina, Meier, Marc-Pascal, Reinhold, Maximilian, Klockner, Friederike Sophie, Lehmann, Wolfgang, Weiser, Lukas
Weitere Verfasser: Roch, Paul Jonathan, Ecker, Carolin, Jäckle, Katharina, Meier, Marc-Pascal, Reinhold, Maximilian, Klockner, Friederike Sophie, Lehmann, Wolfgang, Weiser, Lukas
Quelle: Infection
Verlagsinformationen: Springer Science and Business Media LLC, 2024.
Publikationsjahr: 2024
Schlagwörter: Male, Inflammation, Interleukin-6, Research, Middle Aged, Spine, Inflammation/blood [MeSH], Female [MeSH], Inflammation/diagnosis [MeSH], Aged [MeSH], Biomarkers/blood [MeSH], Humans [MeSH], Prospective Studies [MeSH], Middle Aged [MeSH], Male [MeSH], Surgical Wound Infection/diagnosis [MeSH], Inflammatory marker, C-Reactive Protein/analysis [MeSH], Surgical site infection, Interleukin-6/blood [MeSH], Spine/surgery [MeSH], Early Diagnosis [MeSH], Spine surgery, Surgical Wound Infection/blood [MeSH], Procalcitonin/blood [MeSH], 3. Good health, 03 medical and health sciences, Early Diagnosis, C-Reactive Protein, 0302 clinical medicine, Humans, Surgical Wound Infection, Female, Prospective Studies, Procalcitonin, Biomarkers, Aged
Beschreibung: Purpose Early diagnosis of surgical site infections (SSIs) could prevent surgical revision. Inflammatory markers (IMs), such as procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α), seem more accurate in diagnosing SSI than C-reactive protein (CRP) and white blood cell (WBC) count. The aim was to compare the predictive values of CRP, WBC count, PCT, IL-6, and TNF-α in SSI detection. Methods A total of 130 patients undergoing dorsal spondylodesis from 2019 to 2024 were enrolled in a prospective diagnostic study at a maximum care spine center. IMs were measured preoperatively and on the postoperative days (PODs) 1, 2, 3, 5, and 7. Patients with high suspicion of SSI underwent revision surgery. SSI was diagnosed when the microbiological evidence was positive. Patients were divided a posteriori into the non-infection and infection groups. Results IMs of 118 patients (66.9 ± 13.0 years, 61.0% females) were measured. Fifteen of the 118 patients (12.7%) developed an SSI. The groups differed with respect to existing hypertension, number of instrumented segments, region of surgery, CRPPOD1,7, PCTPOD7, and IL-6POD3,5,7. Binary logistic regression for SSI detection including these parameters showed an area under the curve (AUC) of 0.88 (95% CI 0.79–0.98; P POD7 (odds ratio = 1.13; 95% CI 1.05–1.23; P = 0.001), which itself showed an AUC of 0.86 (95% CI 0.75–0.97). Conclusion Compared to CRP, WBC count, PCT, and TNF-α, IL-6 seems to be the critical IM for the early detection of an SSI. Trial registration drks.de: DRKS00033773, date of registration: 29.02.2024, retrospectively registered; Postoperative Markers of Inflammation in Spine Surgery (POMIS) Trial.
Publikationsart: Article
Other literature type
Sprache: English
ISSN: 1439-0973
0300-8126
DOI: 10.1007/s15010-024-02271-4
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38709460
https://resolver.sub.uni-goettingen.de/purl?gro-2/143672
https://repository.publisso.de/resource/frl:6504841
Rights: CC BY
Dokumentencode: edsair.doi.dedup.....7bfe6c08b8d51efeb68c9fd6b74cbff8
Datenbank: OpenAIRE
Beschreibung
Abstract:Purpose Early diagnosis of surgical site infections (SSIs) could prevent surgical revision. Inflammatory markers (IMs), such as procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α), seem more accurate in diagnosing SSI than C-reactive protein (CRP) and white blood cell (WBC) count. The aim was to compare the predictive values of CRP, WBC count, PCT, IL-6, and TNF-α in SSI detection. Methods A total of 130 patients undergoing dorsal spondylodesis from 2019 to 2024 were enrolled in a prospective diagnostic study at a maximum care spine center. IMs were measured preoperatively and on the postoperative days (PODs) 1, 2, 3, 5, and 7. Patients with high suspicion of SSI underwent revision surgery. SSI was diagnosed when the microbiological evidence was positive. Patients were divided a posteriori into the non-infection and infection groups. Results IMs of 118 patients (66.9 ± 13.0 years, 61.0% females) were measured. Fifteen of the 118 patients (12.7%) developed an SSI. The groups differed with respect to existing hypertension, number of instrumented segments, region of surgery, CRPPOD1,7, PCTPOD7, and IL-6POD3,5,7. Binary logistic regression for SSI detection including these parameters showed an area under the curve (AUC) of 0.88 (95% CI 0.79–0.98; P POD7 (odds ratio = 1.13; 95% CI 1.05–1.23; P = 0.001), which itself showed an AUC of 0.86 (95% CI 0.75–0.97). Conclusion Compared to CRP, WBC count, PCT, and TNF-α, IL-6 seems to be the critical IM for the early detection of an SSI. Trial registration drks.de: DRKS00033773, date of registration: 29.02.2024, retrospectively registered; Postoperative Markers of Inflammation in Spine Surgery (POMIS) Trial.
ISSN:14390973
03008126
DOI:10.1007/s15010-024-02271-4