Macrophage Migration Inhibitory Factor Predicts Outcome in Complex Aortic Surgery

International Journal of Molecular Sciences

Tobias Schuerholz¹  Gereon Schälte²  Christian Stoppe³  Lukas Martin³  Gernot Marx³  Ann Christina Foldenauer⁴  Alexander Gombert⁵  Jochen Grommes⁵  Johannes Kalder⁵  Michael Jacobs⁵ 

[1] Department of Anaesthesia and Intensive Care, University of Rostock, 18059 Rostock, Germany;Department of Anesthesiology, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany;Department of Intensive Care and Intermediate Care, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany;Department of Medical Statistics, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany;European Vascular Center Aachen-Maastricht, Department of Vascular Surgery University Hospital Aachen, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany;

关键词: macrophage migration inhibitory factor;    thoracoabdominal aortic aneurysm;    intensive care unit;    survival;   

DOI  :  10.3390/ijms18112374

来源: DOAJ

【 摘 要 】

The perioperative inflammatory response is associated with outcome after complex aortic repair. Macrophage migration inhibitory factor (MIF) shows protective effects in ischemia-reperfusion (IR), but also adverse pro-inflammatory effects in acute inflammation, potentially leading to adverse outcome, which should be investigated in this trial. This prospective study enrolled 52 patients, of whom 29 (55.7%) underwent open repair (OR) and 23 (44.3%) underwent endovascular repair (ER) between 2014 and 2015. MIF serum levels were measured until 72 h post-operatively. We used linear mixed models and ROC analysis to analyze the MIF time-course and its diagnostic ability. Compared to ER, OR induced higher MIF release perioperatively; at 12 h after ICU admission, MIF levels were similar between groups. MIF course was significantly influenced by baseline MIF level (P = 0.0016) and acute physiology and chronic health evaluation (APACHE) II score (P = 0.0005). MIF level at 24 h after ICU admission showed good diagnostic value regarding patient survival [sensitivity, 80.0% (28.4–99.5%); specificity, 51.2% (35.1–67.1%); AUC, 0.688 (0.534–0.816)] and discharge modality [sensitivity, 87.5% (47.3–99.7%); specificity, 73.7% (56.9–86.6%), AUC, 0.789 (0.644–0.896)]. Increased perioperative MIF-levels are related to an increased risk of adverse outcome in complex aortic surgery and may represent a biomarker for risk stratification in complex aortic surgery.

【 授权许可】

Unknown