Is an Elevated Preoperative CRP Level a Predictive Factor for Wound Healing Disorders Following Lumbar Spine Surgery?

Overview

Journal J Pers Med

Date 2024 Jul 27

PMID 39063921

Authors

Anatoli Pinchuk

Michael Luchtmann

Belal Neyazi

Claudia A Dumitru

Klaus Peter Stein

Ibrahim Erol Sandalcioglu

Ali Rashidi

Affiliations

Soon will be listed here.

Abstract

Methods: A retrospective analysis was conducted on a cohort of 3019 patients who underwent lumbar spine surgery over a decade in our department. The study aimed to assess the predictors of wound healing disorders, focusing on laboratory values, particularly inflammatory parameters.

Results: Of the 3019 patients, 2.5% (N = 74) experienced deep or superficial wound healing disorders, showing the significant correlation between C-reactive protein (CRP) levels and these disorders ( = 0.004). A multivariate analysis identified several factors, including age, sex, hypertension, diabetes, cardiac comorbidity, surgical duration, dural injury, and blood loss, as being correlated with wound healing disorders.

Conclusion: Demographic factors, pre-existing conditions, and perioperative variables play a role in the occurrence of adverse effects related to wound healing disorders. Elevated CRP levels serve as an indicator of increased infection risk, though they are not a definitive diagnostic tool for wound healing disorders.

References

Mujagic E, Marti W, Coslovsky M, Zeindler J, Staubli S, Marti R . The role of preoperative blood parameters to predict the risk of surgical site infection. Am J Surg. 2017; 215(4):651-657. DOI: 10.1016/j.amjsurg.2017.08.021. View

Kim J, Ha S, Choi J, Son B . Chronological Changes of C-Reactive Protein Levels Following Uncomplicated, Two-Staged, Bilateral Deep Brain Stimulation. J Korean Neurosurg Soc. 2015; 58(4):368-72. PMC: 4651999. DOI: 10.3340/jkns.2015.58.4.368. View

Stolke D, Sollmann W, Seifert V . Intra- and postoperative complications in lumbar disc surgery. Spine (Phila Pa 1976). 1989; 14(1):56-9. DOI: 10.1097/00007632-198901000-00011. View

Veeravagu A, Patil C, Lad S, Boakye M . Risk factors for postoperative spinal wound infections after spinal decompression and fusion surgeries. Spine (Phila Pa 1976). 2009; 34(17):1869-72. DOI: 10.1097/BRS.0b013e3181adc989. View

Jiang W, Shi H, Deng X, Hou W, Wan D . The incidence of incision infections after lumbar fusion and the significance of dynamically monitoring serum albumin and C-reactive protein levels. Ann Palliat Med. 2021; 10(10):10870-10877. DOI: 10.21037/apm-21-2512. View

Fei Q, Li J, Lin J, Li D, Wang B, Meng H . Risk Factors for Surgical Site Infection After Spinal Surgery: A Meta-Analysis. World Neurosurg. 2015; 95:507-515. DOI: 10.1016/j.wneu.2015.05.059. View

Cui P, Wang P, Hu X, Kong C, Lu S . Comparison of Perioperative Outcomes in Patients Undergoing Short-Level Lumbar Fusion Surgery After Implementing Enhanced Recovery After Surgery: A Propensity Score Matching Analysis Focusing on Young-Old and Old-Old. Clin Interv Aging. 2022; 17:1793-1801. PMC: 9733441. DOI: 10.2147/CIA.S389927. View

Jenny J, Gaudias J, Bourguignat A, Ferard G, Kempf I . [C-reactive protein and transthyretin in early diagnosis of infection after open fractures of the lower limbs (a preliminary study)]. Rev Chir Orthop Reparatrice Appar Mot. 1999; 85(4):321-7. View

Okafor B, Maclellan G . Postoperative changes of erythrocyte sedimentation rate, plasma viscosity and C-reactive protein levels after hip surgery. Acta Orthop Belg. 1998; 64(1):52-6. View

10.

Takenaka S, Makino T, Sakai Y, Kashii M, Iwasaki M, Yoshikawa H . Dural tear is associated with an increased rate of other perioperative complications in primary lumbar spine surgery for degenerative diseases. Medicine (Baltimore). 2019; 98(1):e13970. PMC: 6344202. DOI: 10.1097/MD.0000000000013970. View

11.

Chen Y, Zhao Y, Liu J, Teng Y, Ou M, Hao X . Predictive value of perioperative procalcitonin, C reactive protein and high-sensitivity C reactive protein for the risk of postoperative complications after non-cardiac surgery in elderly patients: a nested case-control study. BMJ Open. 2023; 13(10):e071464. PMC: 10583102. DOI: 10.1136/bmjopen-2022-071464. View

12.

Abt N, Sethi R, Puram S, Varvares M . Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections. Am J Otolaryngol. 2018; 39(3):261-265. DOI: 10.1016/j.amjoto.2018.01.017. View

13.

Patel H, Khoury H, Girgenti D, Welner S, Yu H . Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement of Staphylococcus aureus. Surg Infect (Larchmt). 2016; 18(4):461-473. PMC: 5466015. DOI: 10.1089/sur.2016.186. View

14.

Ji L, Lu T, Wang Y, Jia Y, Yang J, Ma Y . The role of lymphocyte count in the early diagnosis of surgical site infection following posterior lumbar fusion. Eur Rev Med Pharmacol Sci. 2023; 27(9):3941-3946. DOI: 10.26355/eurrev_202305_32300. View

15.

Kanafani Z, Dakdouki G, El-Dbouni O, Bawwab T, Kanj S . Surgical site infections following spinal surgery at a tertiary care center in Lebanon: incidence, microbiology, and risk factors. Scand J Infect Dis. 2006; 38(8):589-92. DOI: 10.1080/00365540600606440. View

16.

Erman T, Demirhindi H, Gocer A, Tuna M, Ildan F, Boyar B . Risk factors for surgical site infections in neurosurgery patients with antibiotic prophylaxis. Surg Neurol. 2005; 63(2):107-12. DOI: 10.1016/j.surneu.2004.04.024. View

17.

Weinstein M, McCabe J, Cammisa Jr F . Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord. 2000; 13(5):422-6. DOI: 10.1097/00002517-200010000-00009. View

18.

Sharouf F, Hussain R, Hettipathirannahelage S, Martin J, Gray W, Zaben M . C-reactive protein kinetics post elective cranial surgery. A prospective observational study. Br J Neurosurg. 2019; 34(1):46-50. DOI: 10.1080/02688697.2019.1680795. View

19.

Grammatico-Guillon L, Baron S, Rosset P, Gaborit C, Bernard L, Rusch E . Surgical site infection after primary hip and knee arthroplasty: a cohort study using a hospital database. Infect Control Hosp Epidemiol. 2015; 36(10):1198-207. DOI: 10.1017/ice.2015.148. View

20.

Wimmer C, Gluch H, Franzreb M, Ogon M . Predisposing factors for infection in spine surgery: a survey of 850 spinal procedures. J Spinal Disord. 1998; 11(2):124-8. View