Inflammation and outcome after general thoracic surgery

Eur J Cardiothorac Surg. 2007 Sep;32(3):431-4. doi: 10.1016/j.ejcts.2007.06.017. Epub 2007 Jul 23.


Objective: To determine whether preoperative inflammation predisposes to major postoperative complications (PC) and poor outcome.

Methods: Prospective data collection of 153 consecutive patients aged 73+/-6 years scheduled for lung resection at a tertiary cancer center. High sensitivity C-reactive protein (CRP) and interleukin (IL)-6 levels were measured before surgery, on arrival to the postanesthesia care unit, and on the first morning after surgery.

Results: PC occurred in 9/153 (5.9%) patients. In comparison to patients without PC, those with PC had a greater history of hypertension (P=0.047), higher frequency of non-steroidal anti-inflammatory drug use (P=0.007) and had a lower preoperative albumin level, 3.75+/-0.65 g/dl versus 4.28+/-0.33 g/dl, P=0.03. Receiver operating characteristic analysis demonstrated a strong association between PC and preoperative CRP (area under the curve of 0.86), albumin (area under the curve of 0.86) and less so for IL-6 (area under the curve of 0.79).

Conclusions: Markers of inflammation, CRP and IL-6, can help distinguish patients who are at high risk for major PC. These preliminary and novel data suggest that in addition to low albumin, a previously described marker of outcome, systemic inflammation is likely to be important in the pathogenesis of important PC.

MeSH terms

  • Aged
  • Biomarkers
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Inflammation / metabolism*
  • Inflammation Mediators / blood
  • Interleukin-6 / blood*
  • Male
  • Postoperative Complications / prevention & control*
  • Predictive Value of Tests
  • Prognosis
  • Serum Albumin / analysis
  • Thoracic Surgical Procedures / adverse effects*


  • Biomarkers
  • Inflammation Mediators
  • Interleukin-6
  • Serum Albumin
  • C-Reactive Protein