Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study.
<h4>Introduction</h4>Postoperative hyperinflammation increases infection risk. We hypothesized that interleukin-6 (IL-6) is an early predictor of infection after pulmonary cancer surgery.<h4>Methods</h4>A two-centre prospective cohort study, including consecutive elective pul...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0326537 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850121374863982592 |
|---|---|
| author | Ted Reniers Peter G Noordzij Eelco J Veen Erik F N Hofman Anne Marlies Taselaar W Anton Visser Pim van der Heiden Stefan Boeckx Judith M A Emmen Ineke M Dijkstra Olaf L Cremer Lisette M Vernooij Thijs C D Rettig |
| author_facet | Ted Reniers Peter G Noordzij Eelco J Veen Erik F N Hofman Anne Marlies Taselaar W Anton Visser Pim van der Heiden Stefan Boeckx Judith M A Emmen Ineke M Dijkstra Olaf L Cremer Lisette M Vernooij Thijs C D Rettig |
| author_sort | Ted Reniers |
| collection | DOAJ |
| description | <h4>Introduction</h4>Postoperative hyperinflammation increases infection risk. We hypothesized that interleukin-6 (IL-6) is an early predictor of infection after pulmonary cancer surgery.<h4>Methods</h4>A two-centre prospective cohort study, including consecutive elective pulmonary cancer surgery patients. The primary outcome was any postoperative infection within 30 days. Multivariable logistic regression was used to create a core model (age, sex, surgery duration and Charlson comorbidity index) to which maximum IL-6, C-reactive protein (CRP), procalcitonin (PCT) concentrations and white blood cell count (WBC) between start of anaesthesia and 24 hours were added. The predictive performance of the models was assessed.<h4>Results</h4>170 patients were analysed, of whom 38 (22%) developed a postoperative infection. IL-6 concentrations peaked 6 hours postoperatively, whereas CRP had not yet reached peak levels at 24 hours (time of prediction). Maximum IL-6 concentrations were associated with postoperative infection (adjusted odds ratio (aOR) 1.04 per 10 pg/ml, 95% confidence interval (CI) 1.00-1.09, p = 0.047) as was CRP (aOR 1.01 per mg/L, 1.00-1.03, p = 0.032). WBC and PCT were not associated with postoperative infection. The c-statistic of the prediction models that included IL-6 or CRP concentrations were 0.67 (95%CI: 0.56-0.77) and 0.68 (0.57-0.77), respectively, compared to 0.67 (0.56-0.76) for the core model. IL-6 and CRP slightly improved calibration by broadening the range of predicted probabilities. Reclassification did not improve.<h4>Conclusion</h4>Plasma IL-6 and CRP levels observed within 24 hours from the start of surgery are associated with postoperative infection risk, yet the added value of these biomarkers to a simple clinical prediction model seems limited. |
| format | Article |
| id | doaj-art-b25b9c8b5dfd41d09e56cc34f8e72fcf |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-b25b9c8b5dfd41d09e56cc34f8e72fcf2025-08-20T02:35:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01206e032653710.1371/journal.pone.0326537Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study.Ted ReniersPeter G NoordzijEelco J VeenErik F N HofmanAnne Marlies TaselaarW Anton VisserPim van der HeidenStefan BoeckxJudith M A EmmenIneke M DijkstraOlaf L CremerLisette M VernooijThijs C D Rettig<h4>Introduction</h4>Postoperative hyperinflammation increases infection risk. We hypothesized that interleukin-6 (IL-6) is an early predictor of infection after pulmonary cancer surgery.<h4>Methods</h4>A two-centre prospective cohort study, including consecutive elective pulmonary cancer surgery patients. The primary outcome was any postoperative infection within 30 days. Multivariable logistic regression was used to create a core model (age, sex, surgery duration and Charlson comorbidity index) to which maximum IL-6, C-reactive protein (CRP), procalcitonin (PCT) concentrations and white blood cell count (WBC) between start of anaesthesia and 24 hours were added. The predictive performance of the models was assessed.<h4>Results</h4>170 patients were analysed, of whom 38 (22%) developed a postoperative infection. IL-6 concentrations peaked 6 hours postoperatively, whereas CRP had not yet reached peak levels at 24 hours (time of prediction). Maximum IL-6 concentrations were associated with postoperative infection (adjusted odds ratio (aOR) 1.04 per 10 pg/ml, 95% confidence interval (CI) 1.00-1.09, p = 0.047) as was CRP (aOR 1.01 per mg/L, 1.00-1.03, p = 0.032). WBC and PCT were not associated with postoperative infection. The c-statistic of the prediction models that included IL-6 or CRP concentrations were 0.67 (95%CI: 0.56-0.77) and 0.68 (0.57-0.77), respectively, compared to 0.67 (0.56-0.76) for the core model. IL-6 and CRP slightly improved calibration by broadening the range of predicted probabilities. Reclassification did not improve.<h4>Conclusion</h4>Plasma IL-6 and CRP levels observed within 24 hours from the start of surgery are associated with postoperative infection risk, yet the added value of these biomarkers to a simple clinical prediction model seems limited.https://doi.org/10.1371/journal.pone.0326537 |
| spellingShingle | Ted Reniers Peter G Noordzij Eelco J Veen Erik F N Hofman Anne Marlies Taselaar W Anton Visser Pim van der Heiden Stefan Boeckx Judith M A Emmen Ineke M Dijkstra Olaf L Cremer Lisette M Vernooij Thijs C D Rettig Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. PLoS ONE |
| title | Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. |
| title_full | Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. |
| title_fullStr | Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. |
| title_full_unstemmed | Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. |
| title_short | Does postoperative plasma IL-6 improve early prediction of infection after pulmonary cancer surgery? A two-centre prospective study. |
| title_sort | does postoperative plasma il 6 improve early prediction of infection after pulmonary cancer surgery a two centre prospective study |
| url | https://doi.org/10.1371/journal.pone.0326537 |
| work_keys_str_mv | AT tedreniers doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT petergnoordzij doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT eelcojveen doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT erikfnhofman doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT annemarliestaselaar doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT wantonvisser doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT pimvanderheiden doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT stefanboeckx doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT judithmaemmen doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT inekemdijkstra doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT olaflcremer doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT lisettemvernooij doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy AT thijscdrettig doespostoperativeplasmail6improveearlypredictionofinfectionafterpulmonarycancersurgeryatwocentreprospectivestudy |