Marcinek Mateusz, Tkocz Michał, Marczewski Kamil, Partyka Robert, Kukulski Leszek, Młynarek-Śnieżek Krystyna, Sędziak-Marcinek Bogumiła, Rajwa Paweł, Berezowski Adam, Kokocińska Danuta
Department of Urology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Plac Medyków 1, 41-200 Sosnowiec, Poland.
Department of Emergency Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Francuska 20, 40-027 Katowice, Poland.
Biomedicines. 2023 Aug 4;11(8):2195. doi: 10.3390/biomedicines11082195.
The application and prognostic nature of systemic inflammatory reaction syndrome (SIRS) is still being researched, as using SIRS parameters to predict patient status is cheap, efficient, fast, and easy. The study aimed to determine SIRS markers and postoperative complications occurrence in patients undergoing kidney tumor surgery, and to verify if SIRS occurrence depends on age, sex, BMI (body mass index), comorbidities, patients' general condition before the surgery, type of surgery, intraoperative blood loss, or intraoperative ischemia time. Body temperature, heart rate, respiratory rate, and leukocyte count were measured in patients ( = 285) operated on due to a kidney tumor on the first (T0) and third (T3) postoperative day. Univariable and multivariable logistic regression were used to analyze the factors affecting postoperative SIRS and complications occurrence. T0: SIRS developed in patients with higher BMI, >2 ASA points, and more substantial intraoperative blood loss. T3: SIRS developed in obese or overweight patients, with >2 ASA points, significantly higher relative HR change, lower relative body temperature change, respiratory rate, and leukocyte count. BMI values, preoperative general health status, and the amount of intraoperative blood loss in patients undergoing surgery due to a kidney tumor can contribute to SIRS occurrence. Patient's sex, age, tumor size, type of surgery, operated side, and time of intraoperative ischemia do not affect SIRS occurrence.
全身炎症反应综合征(SIRS)的应用及预后性质仍在研究中,因为使用SIRS参数预测患者状况成本低、效率高、速度快且操作简便。该研究旨在确定接受肾肿瘤手术患者的SIRS标志物及术后并发症的发生情况,并验证SIRS的发生是否取决于年龄、性别、体重指数(BMI)、合并症、手术前患者的一般状况、手术类型、术中失血量或术中缺血时间。对285例因肾肿瘤接受手术的患者在术后第1天(T0)和第3天(T3)测量体温、心率、呼吸频率和白细胞计数。采用单变量和多变量逻辑回归分析影响术后SIRS及并发症发生的因素。T0:BMI较高、美国麻醉医师协会(ASA)评分>2分且术中失血量较多的患者发生SIRS。T3:肥胖或超重、ASA评分>2分、相对心率变化明显较高、相对体温变化较低、呼吸频率及白细胞计数较低的患者发生SIRS。因肾肿瘤接受手术患者的BMI值、术前总体健康状况及术中失血量可促使SIRS的发生。患者的性别、年龄、肿瘤大小、手术类型、手术侧别及术中缺血时间不影响SIRS的发生。