Interleukin response in patients treated with abbreviated laparotomy for severe intraabdominal sepsis

Citokinski odgovor pri bolnikih, zdravljenih z metodo odprtega trebuha zaradi hude sepse, povzročene z dogajanjem v trebušni votlini

  • Tomaž Jagrič University Medical Centre Maribor, The Department of Abdominal and General Surgery
  • Maksimiljan Gorenjak University Medical Centre Maribor, Department of Laboratory diagnostics
  • Evgenija Homšak University Medical Centre Maribor, Department of Laboratory diagnostics
  • Bojan Krebs University Medical Centre Maribor, The Department of Abdominal and General Surgery
Keywords: intraabdominal sepsis, surgery, negative wound pressure therapy, interleukin-6, interleukin-10

Abstract

Background: Pro- and anti-inflammatory cytokines play an important role in abdominal sepsis. Studies suggest that the anti-inflammatory response is more detrimental to the patient with abdominal sepsis than the initial pro-inflammatory response. We therefore studied the serum levels of pro-inflammatory and anti-inflammatory interleukins in patients with abdominal sepsis treated by abbreviated laparotomy.

Methods: We performed a prospective study of 42 patients treated by abbreviated laparotomy. The patients were divided into a high-risk (more than two procedures before abdominal closure) group (24 patients) and a low-risk (two or fewer procedures) group (18 patients). The differences and correlations between the serum levels of pro-inflammatory and anti-inflammatory cytokines on days one and ten after the initial procedure were assessed.

Results: The mortality was significantly higher in the high-risk group (41.7% vs. 5.6% in the low-risk group; p = 0.012). IL-10 serum levels were significantly higher in the high-risk group (22.5 pg/mL (IQR 5.25)) compared to the low-risk group (12.15 pg/mL (IQR 6.725)) (p = 0.012). Age was significantly correlated with mortality (p = 0.007). The logarithmic value of IL-10 serum levels on day one (HR: 2.5; 95% CI: 1.109–5.638; p = 0.027) and the IL-10 cut-off value (HR: 3.816; 95% CI: 1.047–13.910; p = 0.042) were significantly correlated with worse disease course in multivariate analysis.

Conclusions: Patients who exhibit a greater anti-inflammatory response on day one are at increased risk of a protracted course and higher mortality. IL-10 serum levels on day one after surgery predict a worse disease course in these patients and could be a useful marker of abdominal sepsis.

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Author Biographies

Tomaž Jagrič, University Medical Centre Maribor, The Department of Abdominal and General Surgery

Maribor, Slovenia.

Maksimiljan Gorenjak, University Medical Centre Maribor, Department of Laboratory diagnostics

Maribor, Slovenia.

Evgenija Homšak, University Medical Centre Maribor, Department of Laboratory diagnostics

Maribor, Slovenia.

Bojan Krebs, University Medical Centre Maribor, The Department of Abdominal and General Surgery

Maribor, Slovenia.

Published
2023-01-20
How to Cite
Jagrič T., Gorenjak M., Homšak E., & Krebs B. (2023). Interleukin response in patients treated with abbreviated laparotomy for severe intraabdominal sepsis. Acta Medico-Biotechnica, 15(2), 17-25. https://doi.org/10.18690/actabiomed.238
Section
Articles