Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study
Postoperative complications after lung surgery are frequent, having a detrimental effect on patients' further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemp...
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| Veröffentlicht in: | PloS one 2018-07, Vol.13 (7), p.e0199807-e0199807 |
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| creator | Kaufmann, Kai B Heinrich, Sebastian Staehle, Hans Felix Bogatyreva, Lioudmila Buerkle, Hartmut Goebel, Ulrich |
| description | Postoperative complications after lung surgery are frequent, having a detrimental effect on patients' further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothesized that patients who show an increased inflammatory response at the time of wound closure and 24 hours after surgery are at risk of postoperative complications within 30 days after surgery.
Postoperative complications (pulmonary, cardiac, neurological and renal) of 96 patients scheduled for lung surgery at the Medical Center-University of Freiburg were analyzed in this prospective, clinical study. Blood samples for cytokine analysis (Interleukin (IL)-6, IL-8, IL-10, Tumor necrosis factor [TNF]-α, IL-1ß and IL12p70) were taken before surgery, at wound closure and 24 hours after surgery. Cytokine levels of patients with and without postoperative complications were analyzed by Receiver operating characteristic (ROC) curve analysis. To adjust the results according to existing covariates a multivariate logistic regression analysis was conducted.
The complication and non-complication group differed significantly according to nicotine dependency, Angiotensin-receptor-II blocker medication, rate of thoracotomy and preoperative lung function. The intraoperative hemodynamic parameters and therapy did not differ between the groups. Twenty-nine patients (30%) developed postoperative complications within 30 days after surgery. Plasma concentrations of IL-6, IL-10 and IL-8 at the time of wound closure and 24 hours after surgery were higher in the complication group. Multivariate regression analysis on postoperative complications revealed an Odds ratio of 56 for patients with IL-6 and IL-8 levels above the 3rd quartile measured on the first postoperative day.
Perioperative detection of increased plasma concentrations of inflammatory cytokines in lung surgery may be used in addition to other clinical predictors to identify patients at risk for postoperative complications.
German Clinical Trials Register 00006961. |
| doi_str_mv | 10.1371/journal.pone.0199807 |
| format | Article |
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Postoperative complications (pulmonary, cardiac, neurological and renal) of 96 patients scheduled for lung surgery at the Medical Center-University of Freiburg were analyzed in this prospective, clinical study. Blood samples for cytokine analysis (Interleukin (IL)-6, IL-8, IL-10, Tumor necrosis factor [TNF]-α, IL-1ß and IL12p70) were taken before surgery, at wound closure and 24 hours after surgery. Cytokine levels of patients with and without postoperative complications were analyzed by Receiver operating characteristic (ROC) curve analysis. To adjust the results according to existing covariates a multivariate logistic regression analysis was conducted.
The complication and non-complication group differed significantly according to nicotine dependency, Angiotensin-receptor-II blocker medication, rate of thoracotomy and preoperative lung function. The intraoperative hemodynamic parameters and therapy did not differ between the groups. Twenty-nine patients (30%) developed postoperative complications within 30 days after surgery. Plasma concentrations of IL-6, IL-10 and IL-8 at the time of wound closure and 24 hours after surgery were higher in the complication group. Multivariate regression analysis on postoperative complications revealed an Odds ratio of 56 for patients with IL-6 and IL-8 levels above the 3rd quartile measured on the first postoperative day.
Perioperative detection of increased plasma concentrations of inflammatory cytokines in lung surgery may be used in addition to other clinical predictors to identify patients at risk for postoperative complications.
German Clinical Trials Register 00006961.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0199807</identifier><identifier>PMID: 29969473</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Anesthesia ; Anesthesiology ; Angiotensin ; Biology and Life Sciences ; Biomarkers ; Clinical trials ; Complications ; Complications and side effects ; Critical care ; Cytokines ; Cytokines - blood ; Dependence ; Female ; Gene expression ; Health care facilities ; Humans ; Inflammation ; Inflammatory response ; Interleukin ; Interleukin 1 ; Interleukin 10 ; Interleukin 6 ; Interleukin 8 ; Lung cancer ; Lung Diseases - blood ; Lung Diseases - pathology ; Lung Diseases - surgery ; Lung surgery ; Lungs ; Male ; Medical personnel ; Medical research ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Multivariate analysis ; Neurological complications ; Nicotine ; Ostomy ; Patients ; Perioperative Care ; Physical Sciences ; Postoperative complications ; Postoperative Complications - blood ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Prognosis ; Prospective Studies ; Pulmonary Surgical Procedures - adverse effects ; Regression analysis ; Research and Analysis Methods ; Respiratory function ; Risk analysis ; Risk Factors ; ROC Curve ; Surgery ; Thoracic surgery ; Tumor necrosis factor ; Ventilators ; Wounds</subject><ispartof>PloS one, 2018-07, Vol.13 (7), p.e0199807-e0199807</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Kaufmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Kaufmann et al 2018 Kaufmann et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4b89ff7a1ed3ee344dd75b28c7695bc2cf798dd619333cfa5613611ef479618b3</citedby><cites>FETCH-LOGICAL-c692t-4b89ff7a1ed3ee344dd75b28c7695bc2cf798dd619333cfa5613611ef479618b3</cites><orcidid>0000-0002-9511-6633</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029786/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029786/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29969473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rosell, Rafael</contributor><creatorcontrib>Kaufmann, Kai B</creatorcontrib><creatorcontrib>Heinrich, Sebastian</creatorcontrib><creatorcontrib>Staehle, Hans Felix</creatorcontrib><creatorcontrib>Bogatyreva, Lioudmila</creatorcontrib><creatorcontrib>Buerkle, Hartmut</creatorcontrib><creatorcontrib>Goebel, Ulrich</creatorcontrib><title>Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Postoperative complications after lung surgery are frequent, having a detrimental effect on patients' further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothesized that patients who show an increased inflammatory response at the time of wound closure and 24 hours after surgery are at risk of postoperative complications within 30 days after surgery.
Postoperative complications (pulmonary, cardiac, neurological and renal) of 96 patients scheduled for lung surgery at the Medical Center-University of Freiburg were analyzed in this prospective, clinical study. Blood samples for cytokine analysis (Interleukin (IL)-6, IL-8, IL-10, Tumor necrosis factor [TNF]-α, IL-1ß and IL12p70) were taken before surgery, at wound closure and 24 hours after surgery. Cytokine levels of patients with and without postoperative complications were analyzed by Receiver operating characteristic (ROC) curve analysis. To adjust the results according to existing covariates a multivariate logistic regression analysis was conducted.
The complication and non-complication group differed significantly according to nicotine dependency, Angiotensin-receptor-II blocker medication, rate of thoracotomy and preoperative lung function. The intraoperative hemodynamic parameters and therapy did not differ between the groups. Twenty-nine patients (30%) developed postoperative complications within 30 days after surgery. Plasma concentrations of IL-6, IL-10 and IL-8 at the time of wound closure and 24 hours after surgery were higher in the complication group. Multivariate regression analysis on postoperative complications revealed an Odds ratio of 56 for patients with IL-6 and IL-8 levels above the 3rd quartile measured on the first postoperative day.
Perioperative detection of increased plasma concentrations of inflammatory cytokines in lung surgery may be used in addition to other clinical predictors to identify patients at risk for postoperative complications.
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blood</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Pulmonary Surgical Procedures - adverse effects</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Respiratory function</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Tumor necrosis factor</subject><subject>Ventilators</subject><subject>Wounds</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk22L1DAQx4so3nn6DUQLgii4a5qkSfNGWA4fFg5OfHob0nS6m71s00vaw_0KfmrT3d6xlXshhTTp_OY_melMkjzP0DwjPHu_cb1vlJ23roE5yoQoEH-QnGaC4BnDiDw82p8kT0LYIJSTgrHHyQkWggnKyWny5yt441rwqjM3kOpd565MA2nrXW0spFXvTbNKbR-X0PsV-F20QWV0F9I2OkETN6pLvQlXae182rrQHQm6bWuNjgfXhNli0A0t6MH2LtXWNNFm09D11e5p8qhWNsCz8X2W_Pz08cf5l9nF5efl-eJippnA3YyWhahrrjKoCAChtKp4XuJCcybyUmNdc1FUFYvJE6JrlbOMsCyDmnLBsqIkZ8nLg25rXZBjGYPEiBFWMEREJJYHonJqI1tvtsrvpFNG7j84v5LKd0ZbkCjPscgJh0JhWlaxrhpRihGnijNNB60PY7S-3EKlY728shPRqaUxa7lyN5IhLHjBosCbUcC76x5CJ7cmaLBWNeD6_b0pzhETWURf_YPen91IrVRMwDS1i3H1ICoXOeUFRRwPYef3UPGpYGt07LmhPaYObycOkengd7dSfQhy-f3b_7OXv6bs6yN2Dcp26-Bsv--oKUgPoI49FjzUd0XOkBxG5rYachgZOY5MdHtx_IPunG5nhPwFSfgUCw</recordid><startdate>20180703</startdate><enddate>20180703</enddate><creator>Kaufmann, Kai B</creator><creator>Heinrich, Sebastian</creator><creator>Staehle, Hans Felix</creator><creator>Bogatyreva, Lioudmila</creator><creator>Buerkle, Hartmut</creator><creator>Goebel, Ulrich</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-9511-6633</orcidid></search><sort><creationdate>20180703</creationdate><title>Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study</title><author>Kaufmann, Kai B ; Heinrich, Sebastian ; Staehle, Hans Felix ; Bogatyreva, Lioudmila ; Buerkle, Hartmut ; Goebel, Ulrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4b89ff7a1ed3ee344dd75b28c7695bc2cf798dd619333cfa5613611ef479618b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Angiotensin</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Critical care</topic><topic>Cytokines</topic><topic>Cytokines - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaufmann, Kai B</au><au>Heinrich, Sebastian</au><au>Staehle, Hans Felix</au><au>Bogatyreva, Lioudmila</au><au>Buerkle, Hartmut</au><au>Goebel, Ulrich</au><au>Rosell, Rafael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-07-03</date><risdate>2018</risdate><volume>13</volume><issue>7</issue><spage>e0199807</spage><epage>e0199807</epage><pages>e0199807-e0199807</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Postoperative complications after lung surgery are frequent, having a detrimental effect on patients' further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothesized that patients who show an increased inflammatory response at the time of wound closure and 24 hours after surgery are at risk of postoperative complications within 30 days after surgery.
Postoperative complications (pulmonary, cardiac, neurological and renal) of 96 patients scheduled for lung surgery at the Medical Center-University of Freiburg were analyzed in this prospective, clinical study. Blood samples for cytokine analysis (Interleukin (IL)-6, IL-8, IL-10, Tumor necrosis factor [TNF]-α, IL-1ß and IL12p70) were taken before surgery, at wound closure and 24 hours after surgery. Cytokine levels of patients with and without postoperative complications were analyzed by Receiver operating characteristic (ROC) curve analysis. To adjust the results according to existing covariates a multivariate logistic regression analysis was conducted.
The complication and non-complication group differed significantly according to nicotine dependency, Angiotensin-receptor-II blocker medication, rate of thoracotomy and preoperative lung function. The intraoperative hemodynamic parameters and therapy did not differ between the groups. Twenty-nine patients (30%) developed postoperative complications within 30 days after surgery. Plasma concentrations of IL-6, IL-10 and IL-8 at the time of wound closure and 24 hours after surgery were higher in the complication group. Multivariate regression analysis on postoperative complications revealed an Odds ratio of 56 for patients with IL-6 and IL-8 levels above the 3rd quartile measured on the first postoperative day.
Perioperative detection of increased plasma concentrations of inflammatory cytokines in lung surgery may be used in addition to other clinical predictors to identify patients at risk for postoperative complications.
German Clinical Trials Register 00006961.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29969473</pmid><doi>10.1371/journal.pone.0199807</doi><tpages>e0199807</tpages><orcidid>https://orcid.org/0000-0002-9511-6633</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2063686039 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Anesthesia Anesthesiology Angiotensin Biology and Life Sciences Biomarkers Clinical trials Complications Complications and side effects Critical care Cytokines Cytokines - blood Dependence Female Gene expression Health care facilities Humans Inflammation Inflammatory response Interleukin Interleukin 1 Interleukin 10 Interleukin 6 Interleukin 8 Lung cancer Lung Diseases - blood Lung Diseases - pathology Lung Diseases - surgery Lung surgery Lungs Male Medical personnel Medical research Medicine Medicine and Health Sciences Middle Aged Multivariate analysis Neurological complications Nicotine Ostomy Patients Perioperative Care Physical Sciences Postoperative complications Postoperative Complications - blood Postoperative Complications - diagnosis Postoperative Complications - etiology Prognosis Prospective Studies Pulmonary Surgical Procedures - adverse effects Regression analysis Research and Analysis Methods Respiratory function Risk analysis Risk Factors ROC Curve Surgery Thoracic surgery Tumor necrosis factor Ventilators Wounds |
| title | Perioperative cytokine profile during lung surgery predicts patients at risk for postoperative complications-A prospective, clinical study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T02%3A52%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Perioperative%20cytokine%20profile%20during%20lung%20surgery%20predicts%20patients%20at%20risk%20for%20postoperative%20complications-A%20prospective,%20clinical%20study&rft.jtitle=PloS%20one&rft.au=Kaufmann,%20Kai%20B&rft.date=2018-07-03&rft.volume=13&rft.issue=7&rft.spage=e0199807&rft.epage=e0199807&rft.pages=e0199807-e0199807&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0199807&rft_dat=%3Cgale_plos_%3EA547840726%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2063686039&rft_id=info:pmid/29969473&rft_galeid=A547840726&rft_doaj_id=oai_doaj_org_article_05529537e8a24bd996c0442074a76c49&rfr_iscdi=true |