Dynamics of inflammation biomarkers C-reactive protein, leukocytes, neutrophils, and CD64 on neutrophils before and after major surgical procedures to recognize potential postoperative infection.

BACKGROUND

Major trauma and soft tissue injuries result in a substantial activation of systemic immune response and post-traumatic complications such as postoperative infections. The aim was to assess the dynamics of expressed inflammatory biomarkers after surgery and to detect possible postoperative infection.

METHODS

A total of 229 patients were included and separated into three different groups, depending on the procedure they underwent (colorectal, maxillofacial, open heart surgery). Biomarkers CD64 on neutrophils, C-reactive protein (CRP), count of leucocytes and neutrophils were measured to detect postoperative infection.

RESULTS

The values of all biomarkers after surgery were generally elevated and had then dropped 48 h after the procedure. The levels were dependent on the type of operation and showed higher levels after more serious procedures. In the patients with postoperative infections the values were considerably higher. Moreover, biomarkers' cut-off values for positive infection were higher from patients who underwent surgery, compared to the cut-off values from patients with no surgical procedure. CD64 index was the only biomarker that could predict postoperative infection (p < 0.001). Other biomarkers could not statistically predict the infection.

CONCLUSIONS

Newly acquired postoperative infection is difficult to diagnose using just biomarkers due to the strong activation of immune response. CD64 index with its slightly higher cut-off (> 1.27) is the only biomarker that could be used as a diagnostic tool to rapidly detect postoperative bacterial infection.