Laishram Kanchana, Borgohain Bhaskar, Laishram Aparna, Khonglah Tashi G, Ruram Alice A, Debbarma Sachlang
Department of Orthopaedics and Trauma, NEIGRIHMS, Shillong, Meghalaya 793018 India.
Department of Biochemistry, NEIGRIHMS, Shillong, Meghalaya 793018 India.
Indian J Orthop. 2024 Jun 25;58(8):1153-1158. doi: 10.1007/s43465-024-01195-3. eCollection 2024 Aug.
Interleukin-6 (IL-6) is a cytokine released in response to tissue injury. Elevated serum IL-6 levels in trauma patients have been linked with increased risk of complications such as inapparent hypoxia (SpO < 94%), acute respiratory distress syndrome, fat embolism syndrome (FES), systemic inflammatory response syndrome, multiple organ dysfunction syndrome and sepsis. This study aims to determine the role of serum IL-6 as surrogate biomarker of post-operative complications after invasive orthopaedic surgeries.
Thirty-seven adults between 18 and 65 years of age undergoing invasive orthopaedic surgeries were included in this hospital-based study. Serum IL-6 levels were estimated serially in the pre-operative period, after 24 h and 7 days post-operatively. Cases were monitored for post-operative complications.
Serum IL-6 levels showed maximum rise in the first 24 h post-operatively especially among older patients (> 60 years). Older patients undergoing bipolar hemiarthroplasty for neck of femur fracture showed highest median post-operative IL-6 level of 258 pg/ml. Serum IL-6 level > 130 pg/ml measured 24 h after surgery was predictive of post-operative complications (sensitivity of 75%). Among the cases with post-operative complications, inapparent hypoxia was the most common complication/event observed. Cases with sub-clinical FES had highest level of serum IL-6 in first 24 h following surgery with median IL-6 level of 300 pg/ml (range 155-444 pg/ml).
Monitoring serum IL-6 level may help in both anticipation and early detection of post-operative complications in patients undergoing invasive orthopaedic surgeries; potentially enhancing patient safety.
白细胞介素-6（IL-6）是一种因组织损伤而释放的细胞因子。创伤患者血清IL-6水平升高与诸如隐匿性缺氧（SpO＜94%）、急性呼吸窘迫综合征、脂肪栓塞综合征（FES）、全身炎症反应综合征、多器官功能障碍综合征和脓毒症等并发症风险增加相关。本研究旨在确定血清IL-6作为侵入性骨科手术后术后并发症替代生物标志物的作用。
本基于医院的研究纳入了37名年龄在18至65岁之间接受侵入性骨科手术的成年人。在术前、术后24小时和术后7天连续测定血清IL-6水平。对病例进行术后并发症监测。
血清IL-6水平在术后最初24小时内升高最为明显，尤其是在老年患者（＞60岁）中。接受股骨颈骨折双极半关节置换术的老年患者术后IL-6水平中位数最高，为258 pg/ml。术后24小时测得的血清IL-6水平＞130 pg/ml可预测术后并发症（敏感性为75%）。在术后并发症病例中，隐匿性缺氧是最常见的并发症/事件。亚临床FES病例在术后最初24小时内血清IL-6水平最高，IL-6水平中位数为300 pg/ml（范围155 - 444 pg/ml）。
监测血清IL-6水平可能有助于预测和早期发现接受侵入性骨科手术患者的术后并发症；潜在地提高患者安全性。
