Optimaler Zeitpunkt zur prothetischen Versorgung von Schenkelhalsfrakturen

Neumaier, Markus; Vester, Helen; Martetschläger, Frank; Freude, Thomas; Scherer, M. A.; Stöckle, Ulrich

doi:10.1007/s00104-010-2043-y

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Therefore, most surgeons refer to temporal patterns rather than the value at a specific time point [ 18 ]. Several studies have investigated CRP kinetics following surgical procedures [ 22 – 26 ]. These studies consistently found that CRP increases after the surgery, peaks on the second day, and then gradually returns to normal around the seventh day.…”

Section: Discussionmentioning

confidence: 99%

Different Kinetics of Perioperative CRP after Hip Arthroplasty for Elderly Femoral Neck Fracture with Elevated Preoperative CRP

Lim

Choi

Lee

et al. 2018

BioMed Research International

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This study aimed to determine the kinetics of four inflammatory markers and to identify the variables that affect the natural kinetics of inflammatory markers in aged patients having hip fractures with and without elevated preoperative CRP. 240 elderly patients who have been operated on for femoral neck fracture with no infectious complications were divided into two groups on elevated preoperative CRP level (>10 mg/L). The temporal values of four inflammatory markers of WBC, neutrophil count (N) (%), ESR, and CRP were assessed eight times every other day until the 14th postoperative day. At 48–60 h postoperatively, mean CRP was markedly higher in patients with preoperatively elevated CRP than in those with nonelevated CRP (122.1 ± 65.9 and 73.7 ± 35.5, p < 0.001). However, the abrupt elevation of CRP in the elevated group was conversely decreased on the 4th-5th postoperative day, demonstrating similar kinetic curves with no significant differences between both groups. For WBC, N (%), and ESR, both groups showed similar patterns of temporal values 14 days after surgery regardless of preoperative CRP level. Our findings could be used as guidelines for patient discharge and during the follow-up period after surgery.

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Section: Discussionmentioning

confidence: 99%

Different Kinetics of Perioperative CRP after Hip Arthroplasty for Elderly Femoral Neck Fracture with Elevated Preoperative CRP

Lim

Choi

Lee

et al. 2018

BioMed Research International

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“…Furthermore, the results show that already on day 1 and 2 a differentiation of the markers between PT+Inf and PT-Inf occurs, which in these cases suggests an early enhanced immune response in the PT+Inf group. It was shown before that primary trauma injury triggers an immunomodulatory response that is associated with an increase in CRP (34). Interleukins play a particularly prominent role in the development of posttraumatic complications und and have been widely studied in relation to trauma (15,16,35).…”

Section: Early Tracking Of Posttraumatic Infection By Biomarkers Is Efficientmentioning

confidence: 99%

Influence of Antibiotic Management on Microbial Selection and Infectious Complications After Trauma

et al. 2021

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Background: The inflammatory response and post-traumatic complications like infections play an important role in the pathophysiology of severe injuries. This study examines the microbiological aspects in anti-infective treatment of trauma patients and their inflammatory response in post-traumatic infections complications.Patients and Methods: A retrospective analysis of prospectively collected data in trauma patients (ISS ≥ 16) over a 1-year period (01/2018 to 12/2018) is provided. Patient population was stratified into severely injured patients without post-traumatic infection (inf-PT), and severely injured patients who developed an infection (inf+PT).Results: Of 114 trauma patients, 45 suffered from post-traumatic infection during the first 10 days of hospitalization. Severely injured patients with concomitant traumatic brain injury (PT+TBI) showed the highest rate of post-traumatic infection. Pro-inflammatory reaction was tracked by levels of Interleukin (IL-)6 (day 3: inf+T 190.8 ± 359.4 pg/dL > inf-PT 56.2 ± 57.7 pg/mL (mean ± SD); p = 0.008) and C-Reactive-Protein (CRP, day 3: inf+PT 15.3 mg/dL > inf-PT 6.7 mg/dL, p = 0.001) which were significantly higher in trauma patients who develop an infectious complication and showed a significant positive correlation with the occurrence of infection. The leading entity of infection was pneumonia followed by infections of the urinary tract mainly caused by gram-negative Enterobacteriaceae. 67.5% of all trauma patients received single-shot antibiosis during initial care in trauma bay. The development of secondary colonization was not relevant positively correlated with single-shot antibiosis (r = 0.013, p = 0.895) and prophylactically calculated antibiotic administration (r = 0.066, p = 0.500).Conclusion: Severely injured trauma patients have an increased risk for development of infectious complications, which mainly is pneumonia followed by infection of the urinary tract mainly caused by gram-negative Enterobacteriaceae. Based on the data in this study, the one-time antibiotic and prophylactic calculated use of antibiotics, like Cephalosporins must be critically discussed in terms of their role in the development of post-traumatic infections and microbial selection.

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“…Neumaier et al [12] reported that the C-reactive protein (CRP) values were significantly lower in early surgery within 24 h after trauma than in delayed surgery. Moreover, they found that a lower postoperative inflammatory reaction after early surgery of hip fractures provides a better outcome when treated with arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of inflammatory response in patients undergoing surgical treatment for early and delayed femoral fractures

Moghtadaei

Otoukesh

Boddouhi

et al. 2019

aoms

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IntroductionIt has been shown that long bone fractures are correlated with the inflammatory response. In the initial injury, surgical reduction and fixation of fractures induce the immunoinflammatory response. This study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures.Material and methodsThis study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures. The patients were randomly divided into two groups using the method of block randomization including early surgery (within 24 h) and delayed surgery (after 48 h). Serum levels of inflammatory markers in both groups including interleukin (IL)-1, 5, 6, tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ) were determined using specific kits. From each patient 10 ml blood was collected for cytokine assay in their serum.ResultsOur findings suggest that serum levels of IL-8 were markedly decreased from 12 h until 48 h postoperatively (p < 0.05). Moreover, the results indicated that serum levels of TNF-α were significantly increased in the early hours, but after 48 h a decreasing trend was detected (p < 0.05). Furthermore, serum levels of IL-10, IFN-γ, and IL-6 were significantly increased from 12 h until 48 h postoperatively (p < 0.05).ConclusionsThe inflammatory status of the patient may be a useful adjunct in clinical decisions. With an improved understanding of the molecular basis of the inflammatory response, and by identifying relevant clinical markers of inflammation, surgeons can better manage the timing of surgical stabilization.

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Optimaler Zeitpunkt zur prothetischen Versorgung von Schenkelhalsfrakturen

Abstract: The lower postoperative inflammatory reaction after early surgery of hip fractures provides a better outcome when treated with arthroplasty.

Cited by 7 publications

References 15 publications

Different Kinetics of Perioperative CRP after Hip Arthroplasty for Elderly Femoral Neck Fracture with Elevated Preoperative CRP

Different Kinetics of Perioperative CRP after Hip Arthroplasty for Elderly Femoral Neck Fracture with Elevated Preoperative CRP

Influence of Antibiotic Management on Microbial Selection and Infectious Complications After Trauma

Evaluation of inflammatory response in patients undergoing surgical treatment for early and delayed femoral fractures

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