Postoperative cytokine levels and their predictive value in critical patients after major abdominal surgery: a retrospective cohort study

Abstract

Background: It remains uncertain as to what impact cytokine expression level has on patient outcomes.The association of serum levels of interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α), and procalcitonin with critically ill patient outcomes after major abdominal surgery still need to be explored. Methods:From January 1, 2018 to June 30, 2019, a retrospective cohort study was conducted on patients admitted to the surgical intensive care unit (SICU). Levels of IL-1β, IL-2, IL-6, IL-8, IL-10, TNF-α, and procalcitonin were assessed in 1,228 patients undergoing major abdominal surgery with blood samples drawn within 24 h after surgery.Results: Of the 1,228 patients admitted to the SICU for the first time, 1,152 survived and 76 patients died, with a mortality rate of 6.2% (76/1,228). The results of univariate and multivariate analyses revealed that non-survivors had higher levels of IL-1β (OR =2.438, P<0.001) and IL-2 (OR =1.561, P=0.006). Of 62 (5.0%) readmitted to the SICU, the data of 59 were collected, and showed 46 patients survived and 13 died, giving a mortality rate of 22.0% (13/59), which was 3.5 times higher than the mortality rate during the first SICU admission. Serum IL-6 level associated with SICU readmission (OR =1.37, P=0.029). Furthermore, non-survivors had a longer SICU stay and higher rates of mechanical ventilation and continuous renal replacement therapy (CRRT).Conclusions: High levels of IL-1β and IL-2 were associated with mortality, and a high level of IL-6 was a risk factor for SICU readmission in critically ill patients who underwent major abdominal surgery. The mortality rate was higher during the second SICU stay.Tril Registration: ChiCTR20000033894.

Skeletal Muscle Mass Index Reduction Rate as a Prognostic Indicator for Patients Undergoing Pancreatectomy for Pancreatic Cancer

“…Low preoperative SMI was also correlated with postoperative complications in patients with pancreatic cancer (14,15). Previous studies have suggested that SMI reduction is associated with increases in the concentration of circulating inflammatory cytokines and with high complication rates (16,17).…”

Relationship between serum thyroid hormone and IL-1β levels and postmortem tissue deiodinase activity in critically ill patients

“…Critical illness is related to metabolic and inflammatory disorders (48). Postoperative serum IL-1b levels are associated with mortality in critically ill patients after major abdominal surgery (49). In addition, it has been shown that IL-1b inhibits thyroid hormone receptor-b1 gene expression (50), which inhibits hepatic D1 expression (51).…”

“…Critical illness has been shown to be associated with disturbed metabolic and inflammatory responses (17). Interleukin-1b (IL-1b) is a pro-inflammatory cytokine that is higher in non-survivors than in critically surviving patients (18). Other studies have shown that IL-1b can cause damage or apoptosis of thyroid follicular cells and promote the onset of autoimmune thyroiditis (19)(20)(21).…”

“…IL-1b is involved in autoimmune thyroiditis by inducing intercellular adhesion molecule-1 on thyroid follicular cells and interfering with the integrity of thyroid epithelium (22,23). More importantly, postoperative serum IL-1b levels in critically ill patients after major abdominal surgery are associated with mortality (24). In addition, it has been shown that IL-1b inhibits thyroid hormone receptor-b1 gene expression (25), which inhibits hepatic D1 expression (26).…”

The Influence of Adjuvants on the Expression of Pro-Inflammatory Cytokines During Spinal Anesthesia

“…Як було показано в дослідженнях Yan Y. та співавт., TNF-α, що виробляється активованими макрофагами, бере участь у системній запальній реакції організму, і рівень його експресії швидко збільшувався після травми [13]. При цьому високі рівні цитокінів безпосередньо пов'язані з рівнем післяопераційної летальності, а високий рівень IL-6 був фактором ризику повторної госпіталізації у відділення інтенсивної терапії у пацієнтів у критичному стані, які перенесли великі абдомінальні операції [13]. До того ж, стресова реакція може спричинити метаболічні та ендокринні порушення, які є фактором ризику масивної кровотечі та інфекції [14].…”