Lymphopenia at 4 Days Postoperatively Is the Most Significant Laboratory Marker for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

Iwata, Eiichiro; Shigematsu, Hideki; Okuda, Akinori; Morimoto, Yoshihiro; Masuda, Keisuke; Nakajima, Hiroshi; Koizumi, Munehisa; Tanaka, Yasuhito

doi:10.4184/asj.2016.10.6.1042

Cited by 12 publications

(11 citation statements)

References 24 publications

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“…Blood Hb levels partially reflect the nutritional status of patients (22,23). Furthermore, when the immunity of a patient is weakened, LYM is decreased and the patient becomes prone to infections, inhibiting wound healing (24).…”

Section: Discussionmentioning

confidence: 99%

Analysis of post‑operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post‑operative enteral nutrition support nursing combined with early oral feeding

et al. 2020

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The present study aimed to analyze the effects of post-operative enteral nutrition support nursing combined with early oral feeding on post-operative efficacy and pharyngeal fistula (PF) healing in patients with laryngeal cancer (LC). A retrospective analysis of 133 patients with LC, who underwent laryngectomy between May 2014 and September 2016, was conducted. Of these patients, 61 patients (control group) were treated with enteral nutrition support nursing combined with nasogastric feeding, and 72 patients (observation group) were treated with enteral nutrition support nursing combined with early oral feeding. Levels of serum albumin (ALB), pre-albumin (PA), hemoglobin (Hb) and the lymphocyte count (LYM) were compared before and after surgery (7 and 14th post-operative days). The post-operative weight, upper arm muscle circumference (UAMC), triceps skinfold (TSF), post-operative infection, adverse reactions and PF healing were also measured. No differences were observed between the control and observation groups before surgery (all P>0.05). ALB, Hb, PA and LYM were significantly decreased in the control group on the 7 and 14th days post-operatively compared with those in the observation group (all P<0.05). Five patients in the control group presented with PF during treatment, and seven patients in the observation group suffered from PF after surgery. No difference in the average healing time of PF, number of patients with post-operative infection and adverse reactions were observed between the two groups (all P>0.05). The weight and UAMC in the observation group, 14 days post-operatively, were significantly higher than those before surgery in the same patients and in the control group (all P<0.05), whereas no difference in TSF (P>0.05) was observed. No differences in weight, UAMC and TSF were revealed in the control group before surgery and on the 14th day post-operatively (all P>0.05). Thus, post-operative enteral nutrition support nursing combined with early oral feeding resulted in significant improvement in the post-operative efficacy of patients with LC and had no effect on PF healing.

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Section: Discussionmentioning

confidence: 99%

Analysis of post‑operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post‑operative enteral nutrition support nursing combined with early oral feeding

et al. 2020

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“…CT, MRI, PET) because these methods are very expensive and requires a lot of time [13][14][15] . Therefore, postoperative laboratory markers are often used to screen SSI due to their objectivity, low cost and convenience 12,16 .…”

Section: Discussionmentioning

confidence: 99%

“…After that, More and more scholars make a profound study at this field. Iwata et al showed that the lymphocyte count of <1,000/µL at 4 days postoperatively was the sole significant independent laboratory marker for early detection of SSI 16. Chao-Jun Shen et al reported 22 that neutrophil/lymphocyte count ratio (NLR)at 4 and 7days post-operation are valuable laboratory predictors for SSI in patients with posterior lumbar spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

Wei¹,

Dang²,

Duan³

et al. 2019

Preprint

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Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

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“…The preoperative C-reactive protein (CRP) level was significantly higher in patients with than without SSI [median (interquartile range), 0.5 (0.09-0.63) vs. 0.03 (0.02-0.15) mg/dL, respectively; P = 0.026]. The immunological parameters such as the neutrophil count, lymphocyte count, and N/L ratio were not different between patients with and without SSI immediately after the end of anesthesia although an elevated N/L ratio is reportedly correlated with the incidence of SSI after posterior lumbar instrumentation surgery [2]. Similarly, the plasma CRP level on both POD 7 and POD 14 but not POD1 was significantly higher in patients with than without SSI [POD 1 4.41 (1.77-6.24) vs. 4.11 (2.46-5.61) mg/dL, respectively, P = 0.979; POD 7 3.55 (2.82-11.68) vs. 1.56 (0.84-2.62) mg/dL, respectively, P < 0.01; and POD 14 7.29 (1.14-9.74) vs. 0.31 (0.14-0.90) mg/dL, respectively, P < 0.01].…”

mentioning

confidence: 90%

Correlation between perioperative immunological changes and the onset of surgical site infection after surgery for scoliosis: a retrospective cohort study

2020

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Lymphopenia at 4 Days Postoperatively Is the Most Significant Laboratory Marker for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

Cited by 12 publications

References 24 publications

Analysis of post‑operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post‑operative enteral nutrition support nursing combined with early oral feeding

Analysis of post‑operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post‑operative enteral nutrition support nursing combined with early oral feeding

Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

Correlation between perioperative immunological changes and the onset of surgical site infection after surgery for scoliosis: a retrospective cohort study

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