Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy
IntroductionPatients undergoing craniotomy are at high risk of perioperative morbidity and mortality due to excessive inflammatory responses. The purpose of the present study is to evaluate the prognostic utility of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1331073/full |
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| author | Liyuan Peng Qi Gan Yangchun Xiao Jialing He Xin Cheng Peng Wang Lvlin Chen Tiangui Li Yan He Weelic Chong Yang Hai Chao You Fang Fang Yu Zhang |
| author_facet | Liyuan Peng Qi Gan Yangchun Xiao Jialing He Xin Cheng Peng Wang Lvlin Chen Tiangui Li Yan He Weelic Chong Yang Hai Chao You Fang Fang Yu Zhang |
| author_sort | Liyuan Peng |
| collection | DOAJ |
| description | IntroductionPatients undergoing craniotomy are at high risk of perioperative morbidity and mortality due to excessive inflammatory responses. The purpose of the present study is to evaluate the prognostic utility of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing craniotomy.MethodsWe performed a retrospective cohort study of patients who underwent craniotomy between January 2011 and March 2021. SIRS was diagnosed based on two or more criteria (hypo-/hyperthermia, tachypnea, leukopenia/leukocytosis, tachycardia). We used univariate and multivariate analysis for the development of SIRS with postoperative 30-day mortality.ResultsOf 12,887 patients who underwent craniotomy, more than half of the patients (n = 6,725; 52.2%) developed SIRS within the first 7 days after surgery, and 157 (1.22%) patients died within 30 days after surgery. In multivariable analyses, SIRS (OR, 1.57; 95% CI, 1.12–2.21) was associated with 30-day mortality. Early SIRS was not predictive of 30-day mortality, whereas delayed SIRS was predictive of 30-day mortality. Abnormal white blood cell (WBC) counts contributed the most to the SIRS score, followed by abnormal body temperature, respiratory rate, and heart rate.ConclusionPostoperative SIRS commonly occurs after craniotomy and is an independent predictor of postoperative 30-day mortality. This association was seen only in delayed SIRS but not early SIRS. Moreover, increased WBC counts contributed the most to the SIRS score. |
| first_indexed | 2024-03-08T17:06:07Z |
| format | Article |
| id | doaj.art-9ce021a7740b4ee9a8198e90b7f284fe |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-08T17:06:07Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-9ce021a7740b4ee9a8198e90b7f284fe2024-01-04T05:04:44ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-01-011010.3389/fsurg.2023.13310731331073Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomyLiyuan Peng0Qi Gan1Yangchun Xiao2Jialing He3Xin Cheng4Peng Wang5Lvlin Chen6Tiangui Li7Yan He8Weelic Chong9Yang Hai10Chao You11Fang Fang12Yu Zhang13Department of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, ChinaDepartment of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United StatesDepartment of Radiology, Thomas Jefferson University, Philadelphia, PA, United StatesDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaCenter for Evidence Based Medical, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, ChinaIntroductionPatients undergoing craniotomy are at high risk of perioperative morbidity and mortality due to excessive inflammatory responses. The purpose of the present study is to evaluate the prognostic utility of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing craniotomy.MethodsWe performed a retrospective cohort study of patients who underwent craniotomy between January 2011 and March 2021. SIRS was diagnosed based on two or more criteria (hypo-/hyperthermia, tachypnea, leukopenia/leukocytosis, tachycardia). We used univariate and multivariate analysis for the development of SIRS with postoperative 30-day mortality.ResultsOf 12,887 patients who underwent craniotomy, more than half of the patients (n = 6,725; 52.2%) developed SIRS within the first 7 days after surgery, and 157 (1.22%) patients died within 30 days after surgery. In multivariable analyses, SIRS (OR, 1.57; 95% CI, 1.12–2.21) was associated with 30-day mortality. Early SIRS was not predictive of 30-day mortality, whereas delayed SIRS was predictive of 30-day mortality. Abnormal white blood cell (WBC) counts contributed the most to the SIRS score, followed by abnormal body temperature, respiratory rate, and heart rate.ConclusionPostoperative SIRS commonly occurs after craniotomy and is an independent predictor of postoperative 30-day mortality. This association was seen only in delayed SIRS but not early SIRS. Moreover, increased WBC counts contributed the most to the SIRS score.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1331073/fullcraniotomymortalitypostoperativesystemic inflammatory response syndromeprognosis |
| spellingShingle | Liyuan Peng Qi Gan Yangchun Xiao Jialing He Xin Cheng Peng Wang Lvlin Chen Tiangui Li Yan He Weelic Chong Yang Hai Chao You Fang Fang Yu Zhang Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy Frontiers in Surgery craniotomy mortality postoperative systemic inflammatory response syndrome prognosis |
| title | Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| title_full | Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| title_fullStr | Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| title_full_unstemmed | Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| title_short | Postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| title_sort | postoperative systemic inflammatory response syndrome predicts increased mortality in patients after elective craniotomy |
| topic | craniotomy mortality postoperative systemic inflammatory response syndrome prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1331073/full |
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