Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 12936-12945
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12936
Value of inflammatory mediator profiles and procalcitonin in predicting postoperative infection in patients with hypertensive cerebral hemorrhage
Rang-Hua Yin, Bin Zhang, Xing-He Zhou, Lu-Ping Cao, Ming Li
Rang-Hua Yin, Bin Zhang, Xing-He Zhou, Lu-Ping Cao, Ming Li, Department of Surgery, Ji’an City Hospital of Traditional Chinese Medicine, Ji’an 343000, Jiangxi Province, China
Author contributions: Yin RH conceptualized and designed the study, and collected and compiled the data; Zhang B provided administrative support; Zhou XH provided the research materials and patients; Cao PL and Li M analyzed and interpreted the data; and all authors wrote and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Ji’an City Hospital of Traditional Chinese Medicine.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rang-Hua Yin, MD, Attending Doctor, Department of Surgery, Ji’an City Hospital of Traditional Chinese Medicine, No. 6 Baiyunshan Road, Qingyuan District, Ji’an 343000, Jiangxi Province, China. 18407200@masu.edu.cn
Received: October 19, 2022
Peer-review started: October 19, 2022
First decision: November 4, 2022
Revised: November 8, 2022
Accepted: November 14, 2022
Article in press: November 14, 2022
Published online: December 16, 2022
Abstract
BACKGROUND

Hypertensive cerebral hemorrhage (HICH) is a common clinical cerebrovascular disease and one of the most serious complications of hypertension. Early warning of the occurrence of infection during treatment and timely anti-infective treatment are of great significance for the early prevention and treatment of postoperative infection in patients with HICH. Changes in the levels of inflammatory mediators, which are closely related to the occurrence and development of postoperative infection, and procalcitonin (PCT), which is a sensitive indicator for diagnosing bacterial infections, are widely used in clinical practice.

AIM

To explore the application value of inflammatory mediator profiles and PCT in predicting postoperative infection in patients with HICH.

METHODS

A total of 271 patients who underwent HICH surgery at our hospital between March 2019 and March 2021 were selected and divided into the infection (n = 80) and non-infection (n = 191) groups according to whether postoperative infection occurred. The postoperative infection status and etiological characteristics of the infective pathogens in the infection group were analyzed. Changes in inflammatory mediator profile indices and PCT levels were compared between the two groups, pre- and postoperatively.

RESULTS

A total of 109 strains of pathogenic bacteria were detected in the infection group, including 67 strains (61.47%) of gram-negative bacteria, 32 strains (29.36%) of gram-positive bacteria, and 10 strains (9.17%) of fungi. The main infection site of the patients in the infection group was the respiratory system (63.75%). Preoperative interleukin (IL)-4, IL-6, IL-10, tumor necrosis factor-α, interferon-γ, and PCT levels were higher in the infection group than in the non-infection group (P < 0.05), and there were no significant differences in the IL-2 Levels between the two groups (P > 0.05). The inflammatory mediator profile indices and PCT levels were higher in the two groups of patients on the first postoperative day than preoperatively (P < 0.05), and were higher than those in the non-infection group (P < 0.05). Logistic regression analysis showed that preoperative IL-6 and PCT levels correlated with postoperative infection (P < 0.05). Operating characteristic curve analysis results showed that the area under the curve (AUC) values of preoperative IL-6 and PCT levels in predicting postoperative infection in patients with HICH were 0.755 and 0.824, respectively. The AUC value of joint detection was 0.866, which was significantly higher than that of the single index (P < 0.05).

CONCLUSION

Preoperative IL-6 and PCT levels are correlated with postoperative infection in patients with HICH. Their detection is clinically significant for early identification of patients at high risk for postoperative infection.

Keywords: Hypertensive cerebral hemorrhage, Postoperative infection, Inflammatory mediator profiles, Procalcitonin, Prediction, Immune function

Core Tip: Early warning of the occurrence of infection during treatment and timely anti-infective treatment are of great significance for the early prevention and treatment of postoperative infection in patients with hypertensive cerebral hemorrhage. Changes in the levels of inflammatory mediators are closely related to the occurrence and development of postoperative infection, and procalcitonin is a sensitive indicator for diagnosing bacterial infections and is widely used in clinical practice.