White blood cell count, leucocyte elastase activity, and serum concentrations of interleukin-6 and C-reactive protein after open appendicectomy.

OBJECTIVE

To investigate the kinetics of interleukin-6 (IL-6), leucocyte elastase complex (elastase), C-reactive protein (CRP), and total white blood cell count (WBC) after open appendicectomy.

DESIGN

Prospective study.

SETTING

Teaching hospital, Sweden.

SUBJECTS

21 patients with suspected acute appendicitis who underwent appendicectomy.

INTERVENTIONS

Serum samples were taken preoperatively and postoperatively on days 1, 2, 6, 10, and 30.

MAIN OUTCOME MEASURES

Changes in IL-6, elastase, and CRP concentrations and WBC postoperatively, and their correlation with complications.

RESULTS

The highest IL-6 concentrations and WBC were found preoperatively, while postoperatively elastase peaked on day 1, and CRP on day 2. One patient developed a suspected deep infection resulting in secondary peaks of IL-6, WBC, and CRP on day 6. Two patients with perforated appendicitis had high preoperative values of IL-6, elastase, and CRP.

CONCLUSIONS

Concentrations of IL-6, elastase, and CRP, and WBC increase after surgical trauma, and can remain high for up to 10 days. It is important to understand the postoperative kinetics for each test. Postoperative complications might best be detected by measuring IL-6 and CRP concentrations, and WBC.