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Erschienen in: Wiener klinische Wochenschrift 23-24/2014

01.12.2014 | original article

Postoperative immunosuppression markers and the occurrence of sepsis in patients with benign and malignant disease

verfasst von: Tamara Alkhamis, MD, PhD, Dubravka Ivić, MD, PhD, Jasenka Wagner, PhD, Josip Ivić, MD, PhD, Blaženka Dobrošević, MSc Medical Biochemistry, Ivana Turina, MD, Kristina Kralik, MSc Mathematics, Jerko Barbić, MD, PhD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2014

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Summary

Aim

To investigate associations between the postoperative immune response and the levels of extracellular circulating DNA (cDNA), C-reactive protein (CRP), neutrophil/lymphocyte (N/L) ratio, and regulatory T (Treg) cells in the peripheral blood and their role as potential predictors of postoperative septic complications.

Methods

This was a prospective observational study involving 115 adult patients who underwent elective surgery. Patients were divided into three groups: with benign disease, with malignant disease, and with malignant disease and administration of dexamethasone. Serum CRP levels, N/L ratio, monocyte human leukocyte antigen-DR (HLA-DR) expression, proportion of Treg cells, and cDNA levels were measured at different time points before and after surgery.

Results

All patients had increased CRP levels after surgery. Septic patients had higher serum CRP levels at baseline. Compared with the other groups, the dexamethasone group had significantly higher CRP levels before and after surgery, a significantly higher N/L ratio before surgery, a significantly lower rise in the N/L ratio after surgery, and a significantly lower HLA-DR expression at baseline, which remained stable after surgery. In the malignant-disease group, we observed a significant postoperative decrease in the HLA-DR expression.

Conclusions

Our results suggest that the immunosuppressive effect of surgery and the presence of a malignant disease may contribute to a higher risk of postoperative sepsis. Preoperative CRP levels may be a reliable predictor of sepsis in oncological patients.
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Metadaten
Titel
Postoperative immunosuppression markers and the occurrence of sepsis in patients with benign and malignant disease
verfasst von
Tamara Alkhamis, MD, PhD
Dubravka Ivić, MD, PhD
Jasenka Wagner, PhD
Josip Ivić, MD, PhD
Blaženka Dobrošević, MSc Medical Biochemistry
Ivana Turina, MD
Kristina Kralik, MSc Mathematics
Jerko Barbić, MD, PhD
Publikationsdatum
01.12.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 23-24/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0613-6

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