Efficacy of National Nosocomial Infection Surveillance score, acute-phase proteins, and interleukin-6 for predicting postoperative infections following major gastrointestinal surgery

Sao Paulo Medical Journal

José Eduardo De Aguilar-nascimento²  Jair Gimenez Marra²  Natasha Slhessarenko¹  Cor Jesus Fernandes Fontes¹ 

[1] ,Universidade Federal de Mato Grosso Department of Surgery Cuiabá Mato Grosso ,Brazil

关键词: C-reactive protein;    IL-6;    Albumin;    Transferrin;    Prealbumin;    Infection;    Surgery;    Proteína C-reativa;    IL-6;    Albumina;    Transferrina;    Infecção;    Cirurgia;   

DOI  :  10.1590/S1516-31802007000100007

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Postoperative infections should be detected earlier. We investigated the efficacy of the National Nosocomial Infection Surveillance (NNIS) score, interleukin-6 (IL-6) and various acute-phase proteins for predicting postoperative infections. DESIGN AND SETTING: Case series study at the Júlio Müller University Hospital. METHODS: Thirty-two patients who underwent major gastrointestinal procedures between June 2004 and February 2005 were studied. The NNIS score and the evolution of serum IL-6 and various acute-phase proteins (C-reactive protein [CRP], albumin, prealbumin and transferrin) were correlated with postoperative infections and length of hospital stay (LOS). RESULTS: NNIS > 1 (p = 0.01) and low preoperative albumin (p = 0.02) significantly correlated with infection. IL-6 and CRP increased significantly more in patients with infections. Multivariate analysis showed greater risk of infection when NNIS > 1 (odds ratio, OR = 10.66; 95% confidence interval, CI: 1.1-102.0; p = 0.04); preoperative albumin < 3 g/dl (OR = 8.77; 95% CI: 1.13-67.86; p = 0.03); CRP > 30 mg/l on the second postoperative day (OR = 8.27; 95% CI: 1.05-64.79; p = 0.03) and > 12 mg/l on the fifth postoperative day (OR = 25.92; 95% CI: 2.17-332.71; p < 0.01); and IL-6 > 25 pg/ml on the fifth postoperative day (OR = 15.46; 95% CI: 1.19-230.30; p = 0.03). Longer LOS was associated with cancer, transferrin, IL-6 and albumin (p < 0.05). CONCLUSIONS: NNIS, albumin, CRP and IL-6 may be useful as predictive markers for postoperative infections. For predicting LOS, malignant condition, transferrin, albumin and IL-6 are useful.

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