Interleukin-6 as inflammatory marker of surgical site infection following spinal surgery

Lenski, Markus; Tonn, Joerg‐Christian; Siller, Sebastian

doi:10.1007/s00701-020-04628-8

Cited by 13 publications

(11 citation statements)

References 44 publications

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“…The studies on postoperative wound infection after lumbar fusion are mostly focused on the analysis of risk factors. It is believed that the increase of postoperative C-reactive protein (CRP) level and the decrease of albumin (ALB) level are independent risk factors for postoperative wound infection (5,6). However, there are few reports on the changes of the two and whether they can be used as predictor of postoperative wound infection.…”

Section: Introductionmentioning

confidence: 99%

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Jiang¹,

Shi²,

Deng³

et al. 2021

Ann Palliat Med

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Background: To explore the incidence of incision infections and dynamically monitor albumin (ALB) and C-reactive protein (CRP) levels after lumbar fusion.Methods: A total of 1,773 patients undergoing lumbar fusion in our hospital from March 2011 to March 2021 were selected and divided into the infection group and the non-infection group according to whether incision infections occurred postoperatively. The incidence of postoperative incision infections, the pathogenic characteristics and drug resistance of the pathogenic bacteria in patients in the infection group were analyzed. The general clinical data, serum ALB and CRP levels at different time points were compared between the two groups of patients, and the correlation between ALB and CRP levels was analyzed.ROC curve was used to evaluate the predictive value of serum ALB and CRP levels on the incidence of postoperative incision infections.Results: Of the 1,773 patients, 41 (2.31%) experienced postoperative incision infections. A total of 57 pathogens were detected, including 36 gram-negative bacteria (63.16%), 18 gram-positive bacteria (31.58%), and 3 fungi (5.26%). Among gram-negative bacteria, Pseudomonas aeruginosa had the highest resistance to ampicillin. Among gram-positive bacteria, Staphylococcus aureus had the highest resistance to penicillin and erythromycin. The age, BMI, the number of diabetes patients, levels of serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and procalcitonin (PCT) IL-8 at 1 d after operation in the infection group were significantly higher than those in the non-infection group (P<0.05). The serum ALB and CRP levels of the two groups differed over time, and the differences were statistically significant in terms of time, inter-group, time and inter-group interaction factors (P<0.05). Correlation analysis showed that ALB was significantly negatively correlated with CRP expression. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) value of combined ALB and CRP detection was 0.856, which was significantly higher than that of single detection with ALB or CRP (P<0.05).Conclusions: Gram-negative bacterial infection was the main type of incision infection in patients after lumbar fusion. The changes in ALB and CRP levels were related to the incidence of postoperative incision infections.

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Section: Introductionmentioning

confidence: 99%

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Jiang¹,

Shi²,

Deng³

et al. 2021

Ann Palliat Med

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“…However, confounding factors after spinal surgery often affect their sensitivity and specificity. In recent years, studies have suggested that markers such as c (SAA), procalcitonin (PCT), interleukin-6 (IL-6), and leukocyte esterase can serve as crucial auxiliary diagnosis modalities for spinal SSI, with better predictive effect than CRP and leukocyte levels [ 15 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection in spinal surgery: a bibliometric analysis

Wang

Lin

Yao³

et al. 2023

J Orthop Surg Res

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Background Surgical site infection (SSI) is a common complication in spinal surgery that can significantly affect the patient's prognosis. Despite advances in surgical techniques and infection control measures, SSI remains a considerable concern for healthcare providers and patients alike. In recent years, there has been a steady increase in studies related to SSI in spine surgery, leading to the publication of numerous informative articles. However, the current state and trends of research in the field of spinal SSI remain unclear. This study aims to conduct a bibliometric analysis of SSI-related articles in spine surgery to identify research status and trends. Meanwhile, we identify the top 100 most cited articles for further analysis. Methods We searched for all articles related to spinal SSI in the Web of Science Core Collection, recording the publication year, country, journal, institution, keywords, and citation frequency for further analysis. In addition, we identified and analyzed the top 100 most cited articles. Results A total of 307 articles related to spinal SSI were identified. All of these articles were published between 2008 and 2022, with the number of publications showing an increasing trend over the years. The related articles originated from 37 countries, with the USA contributing the most (n = 138). The institution with the highest number of publications and citations was Johns Hopkins University (14 articles; 835 citations). Among the journals, Spine had the highest number of articles (n = 47). The prevention of spinal SSI has been a research hotspot in recent years. Among the top 100 most cited articles, the most common research theme was the risk factors associated with spinal SSI. Conclusions In recent years, research related to spinal SSI has attracted the attention of numerous clinicians and scholars. As the first bibliometric analysis of spinal SSI, our study aims to provide pragmatic guidance for clinicians to learn the research status and trends in this field and improve their vigilance toward SSI.

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“…Current research is focused on the behavior of serum biomarkers in the early postoperative period [ 17 ], where the white blood cell count, CRP, ESR, serum amyloid A, and PCT have been established as the conventional biomarkers [ 24 ]. Research for these biomarkers, as well as other new ones, relies primarily on retrospective cohorts on a single-measurement basis [ 11 , 22 , 28 - 32 ] with few prospective studies performed up to date [ 17 , 24 , 29 ], representing a significant limitation in the validity of results. Although several biomarkers exist in current research, they are studied individually [ 17 ] for a heterogenous group of illnesses in the spectrum of spinal infection with patients undergoing different surgical procedures [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The neutrophil-to-lymphocyte ratio is another marker that has constantly demonstrated diagnostic usefulness in the early postoperative period, with reported cutoff values ranging from 3.21 to 3.87 for differentiating postoperatory state from a spinal infection; however, this information is based on retrospective cohorts [ 25 , 38 ]. Finally, many other biomarkers, such as IL-6, retinol-binding protein, prealbumin, and PSP, among others, have been studied with contradictory evidence and no clear practical usefulness [ 1 , 11 , 22 , 24 ]. The expression of DKK1 has been recently evaluated in the context of osteomyelitis [ 39 ] and infectious processes [ 40 - 42 ] but as far as we know, there exist no reports of spinal infections.…”

Section: Discussionmentioning

confidence: 99%

“…Current research has focused on serum biomarkers to detect spinal infection at the early stages of disease [ 21 , 22 ]; nevertheless, most rely on retrospective cohorts or case series and a scarcity of prospective cohorts. Adding to this problem is that serum biomarkers are studied individually and at different time points while having a heterogenous group of patients who had undergone spinal surgery because of a diversity of spine affections treated with different surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

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The Inflammatory Biomarkers Behavior Profile of Patients Following Elective Degenerative Spine Surgery and Differences Compared to Those Coursing With a Postoperative Spinal Infection: Protocol for a Systematic Review

Rangel¹,

Ponce²,

Chew³

et al. 2023

JMIR Res Protoc

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Background The incidence of postoperative spinal infection (PSI) ranges from 0% to 10%, with devastating effects on the patient prognosis because of higher morbidity while increasing costs to the health care system. PSIs are elusive and difficult to diagnose, especially in the early postoperative state, because of confusing clinical symptoms, rise in serum biomarkers, or imaging studies. Current research on diagnosis has focused on serum biomarkers; nevertheless, most series rely on retrospective cohorts where biomarkers are studied individually and at different time points. Objective This paper presents the protocol for a systematic review that aims to determine the inflammatory biomarker behavior profile of patients following elective degenerative spine surgery and their differences compared to those coursing with PSIs. Methods The proposed systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. This protocol was registered at PROSPERO on January 19, 2022. We will include studies related to biomarkers in adult patients operated on for degenerative spinal diseases and those developing PSIs. The following information will be extracted from the papers: (1) study title; (2) study author; (3) year; (4) evidence level; (5) research type; (6) diagnosis group (elective postoperative degenerative disease or PSI); (7a) region (cervical, thoracic, lumbosacral, and coccygeal); (7b) type of infection by anatomical or radiological site; (8) surgery type (including instrumentation or not); (9) number of cases; (10) mean age or individual age; (11) individual serum biomarker values from the preoperative state up to 90 days postoperative for both groups, including (10a) interleukin-6, (10b) presepsin, (10c) erythrocyte sedimentation rate, (10d) leukocyte count, (10e) neutrophil count, (10f) C-reactive protein, (10g) serum amyloid, (10h) white cell count, (10i) albumin, (10j) prealbumin, (10k) procalcitonin, (10l) retinol-associated protein, and (10m) Dickkopf-1; (11) postoperative days at symptoms or diagnosis; (12) type of organism; (13) day of starting antibiotics; (14) duration of treatment; and (15) any biases (including comorbidities, especially those affecting immunological status). All data on biomarkers will be presented graphically over time. Results No ethical approval will be required, as this review is based on published data and does not involve interaction with human participants. The search for this systematic review commenced in February 2021, and we expect to publish the findings in mid-2023. Conclusions This study will provide the behavior profile of biomarkers for PSI and patients following elective surgery for degenerative spinal diseases from the preoperative period up to 90 days postoperative, providing cutoff values on the day of diagnosis. This research will provide clinicians with highly trustable cutoff reference values for PSI diagnosis. Finally, we expect to provide a basis for future research on biomarkers that help diagnose more accurately and in a timely manner in the early stages of illness, ultimately impacting the patient’s physical and mental health, and reducing the disease burden. Trial Registration PROSPERO CRD42022304645; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=304645 International Registered Report Identifier (IRRID) DERR1-10.2196/41555

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Interleukin-6 as inflammatory marker of surgical site infection following spinal surgery

Cited by 13 publications

References 44 publications

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels

Surgical site infection in spinal surgery: a bibliometric analysis

The Inflammatory Biomarkers Behavior Profile of Patients Following Elective Degenerative Spine Surgery and Differences Compared to Those Coursing With a Postoperative Spinal Infection: Protocol for a Systematic Review

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