Abstract
Background: The aim of this study was to identify an inflammatory marker with fast and predictable kinetics to enable future discrimination between normal postoperative inflammation and potential infection after total hip and knee arthroplasty cases.
Methods: Changes in serum levels of C-reactive protein (CRP), interleukins (IL) 1β, 6 and 8 and NT-proCNP peptide were measured before and during first 5 postoperative days in 100 patients undergoing total hip or knee arthroplasty. We also compared two methods to describe the magnitude of inflammation – applying separate two sample tests at each time point, and summary measures – area under the curve (AUC).
Results: IL-6 showed a similar kinetics pattern to the CRP in response to surgical trauma. Significantly greater level changes in all markers but NT-proCNP were observed in knee patients. Persisting high levels of CRP, but not other markers, were observed in obese hip patients. IL-6 was found to be an adjunct to routine CRP use.
Conclusions: IL-6 has faster kinetics and is less influenced by patient weight, therefore it seems to be more useful in clinical practice. Summary measures describe the inflammatory response well and are easier to analyze than multiple analyses of single time points.
Acknowledgments
Authors wish thank all participants of the study for their cooperation and the staff of the anesthesia and orthopedic units for collection of samples. Authors also wish to thank all who contributed to this article through collegial discussions and comments.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Financial support: The study was supported by grants from the National Science Centre (N N403 1064 40) and the Medical Centre of Postgraduate Education in Warsaw, (2012/KOCZNR) Poland.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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