CRP and leukocyte-count after lumbar spine surgery: fusion vs. nucleotomy

Kraft, C. N.; Krüger, Tobias; Westhoff, Jörn; Lüring, C.; Weber, O.; Wirtz, Dieter Christian; Pennekamp, P. H.

doi:10.3109/17453674.2011.588854

Cited by 49 publications

(61 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of the 34 articles that underwent full-text review, 12 [22][23][24][25][26][27][28][29][30][31][32][33] met eligibility criteria for inclusion in the meta-analysis and 22 were excluded. The most common reasons for exclusion of the 22 studies were: criteria for the diagnosis of SSI not reported and/or CDC/NNIS criteria not applied [34][35][36][37][38][39][40][41][42][43][44][45][46][47], non-scalar definitions of obesity used [47][48][49], risk estimates of the association between obesity/BMI and SSI not reported or raw data not provided to calculate risks [44,47,[50][51][52][53], and analyses restricted to deep wound infections [54,55].…”

Section: Literature Search and Systematic Review Resultsmentioning

confidence: 99%

Body mass index and risk of surgical site infection following spine surgery: a meta-analysis

2013

View full text Add to dashboard Cite

Purpose Inconsistent results have been reported in the literature on the association between obesity, expressed as increased body mass index (BMI), and risk for surgical site infection (SSI) following spine surgery. The objective of this study was to review and quantify the association between increased BMI and risk of spinal SSI in adults. Methods We performed a comprehensive search for relevant studies using PubMed, Embase, and references of published manuscripts. Study-specific risk measures were transformed into slope estimates and combined using the random effects meta-analysis model to establish the risk of SSI associated with every 5-unit increase in BMI. Results Thirty-four articles underwent full-text review. Variations were noted among these studies in relation to SSI diagnosis criteria and BMI cut-off levels used to define obesity. Data from 12 retrospective studies were included in the analyses. Results showed that BMI was significantly positively associated with the risk of spinal SSI. Unadjusted risk estimates demonstrated that a 5-unit increase in BMI was associated with 13 % increased risk of SSI [Crude odds ratio (OR): 1.13; 95 % CI: 1.07-1.19, p\ 0.0001]. Pooling of risk estimates adjusted for diabetes and other confounders resulted in a 21 % increase in risk of spinal SSI for every 5-unit increase in BMI (adjusted OR: 1.21; 95 % CI 1.13-1.29, p \ 0.0001). ConclusionHigher BMI is associated with the increased risk of SSI following spine surgery. Prospective studies are needed to confirm this association and to determine whether other measures of fat distribution are better predictors of risk of SSI.

show abstract

Section: Literature Search and Systematic Review Resultsmentioning

confidence: 99%

Body mass index and risk of surgical site infection following spine surgery: a meta-analysis

2013

View full text Add to dashboard Cite

show abstract

“…Biomarkers, such as elevated serum C-reactive protein (CrP), white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESr) can assist in diagnosing deep subfascial infection, but often are not diagnostic. In adults with instrumented spinal fusion, CrP peaks at second postoperative day, and it may remain elevated for almost 6 weeks making differential diagnosis of systemic inflammatory response and deep surgical wound infection difficult (7)(8)(9)(10). Similarly, ESr peaks on fourth postoperative day and may remain elevated for 6 weeks after instrumented spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Normal behavior of plasma procalcitonin in adolescents undergoing surgery for scoliosis

et al. 2014

View full text Add to dashboard Cite

Background and Aims: surgical site infections are relatively common after spinal deformity surgery. early detection of deep wound infections is important, since it may allow retention of spinal instrumentation. however, serum c-reactive protein and erythrocyte sedimentation rate may remain elevated for almost 6 weeks, making differential diagnosis of systemic inflammatory response and acute deep bacterial wound infection difficult. Plasma procalcitonin has been suggested to be a useful indicator for bacterial infection. however, there are no studies evaluating behavior of procalcitonin in patients undergoing major spine surgery with instrumentation.Materials and Methods: a total of 50 consecutive adolescents (37 idiopathic scoliosis and 13 neuromuscular scoliosis, mean age = 15 years at surgery and follow-up time = 21 months (range = 12-29 months)) undergoing scoliosis surgery participated in this prospective follow-up study. White blood cell count, serum c-reactive protein, and plasma procalcitonin levels were measured on the day before surgery, on the day of surgery, and daily thereafter for 1 week. None of the patients developed signs of acute or delayed wound infection during the follow-up period; however, two neuromuscular scoliosis patients developed severe postoperative pneumonia, and their inflammatory parameter data will be reported separately.Results: Plasma procalcitonin levels peaked on the first postoperative day (mean = 0.19 ng/ml, range = 0.04-1.29 ng/ml), and mean values were less than 0.5 ng/ml during the whole first postoperative week, while c-reactive protein remained elevated during the whole first postoperative week (highest mean value = 63.8 mg/l (range = 5-248 mg/l) on third postoperative day). Patients with idiopathic scoliosis had lower c-reactive protein levels (p < 0.05 from first to sixth postoperative day) and lower procalcitonin levels (p < 0.05 from third to seventh postoperative day) than neuromuscular scoliosis patients. two

show abstract

“…Several authors have considered various laboratory parameters in the detection and monitoring of early surgical site infection after spinal surgery including C-reactive protein levels, [8][9][10] procalcitonin, 11,12 and granulocyte elastase. 13 To our knowledge, no data exist detailing the prognostic significance of the admission inflammatory marker levels on aiding the detection and diagnosis of spontaneous spinal infection.…”

mentioning

confidence: 99%

Admission inflammatory markers and isolation of a causative organism in patients with spontaneous spinal infection

Torrie

Leonidou

Harding

et al. 2013

Ann R Coll Surg Engl

View full text Add to dashboard Cite

INTRODUCTION The purpose of this study was to investigate the significance of the inflammatory markers on admission in the isolation of a causative pathogen in patients with spinal infection. Spinal infection is treated frequently at spinal units and can encompass a broad range of clinical entities. Its diagnosis is often delayed because of the difficulty of identifying the responsible pathogen. METHODS Patients with spinal infection treated in our institution over a period of eight years were identified and their notes studied retrospectively. Admission C-reactive protein (CRP), white cell count (WCC) as well as co-morbidities and mode of pathogen identification were recorded. Overall, 96 patients were included in the study. RESULTS The CRP levels on admission were correlated significantly with the overall potential for isolation of a pathogen (p<0.0001) and positive biopsy cultures (p=0.0016). Admission WCC levels were associated significantly with the overall potential for isolation of a pathogen (p=0.0003) and positive biopsy cultures (p=0.0023). Both CRP and WCC levels were significantly negatively correlated with the duration of the preceding symptoms (p=0.0003 and p<0.0001 respectively). Delay in presentation was significantly negatively correlated with organism isolation (p=0.0001). Multivariate analyses identified the delay in presentation as the strongest independent variable for organism isolation (p=0.014) in cases of spontaneous spinal infection when compared with the admission CRP level (p=0.031) and WCC (p=0.056). CONCLUSIONS In spontaneous spinal infection, delay in presentation is the strongest independent variable for organism isolation. High inflammatory marker levels on admission are a useful prognostic marker for the overall potential of isolating a causative organism either by blood cultures or by biopsy in patients with negative blood cultures. Furthermore, the admission inflammatory marker levels allow for treating surgeons to counsel their patients of the likelihood of achieving a positive microbiological yield from biopsy.

show abstract

CRP and leukocyte-count after lumbar spine surgery: fusion vs. nucleotomy

Cited by 49 publications

References 17 publications

Body mass index and risk of surgical site infection following spine surgery: a meta-analysis

Body mass index and risk of surgical site infection following spine surgery: a meta-analysis

Normal behavior of plasma procalcitonin in adolescents undergoing surgery for scoliosis

Admission inflammatory markers and isolation of a causative organism in patients with spontaneous spinal infection

Contact Info

Product

Resources

About