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Interleukin-6 as inflammatory marker of surgical site infection following spinal surgery

  • Original Article - Infection
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Abstract

Background

In order to elucidate whether serum inflammatory markers identify patients with local surgical site infection(SSI) as underlying disease for recurrent or new symptomatology following spine surgery, we evaluated the diagnostic potential of interleukin-6(IL-6) as a marker of SSI. The diagnostic significance of IL-6 was compared to the standard serum inflammatory markers C-reactive protein(CRP) and white blood cell count (WBCC).

Method

Ninety-eight consecutive patients with readmission due to recurrent or new symptomology after spinal surgery of degenerative spine disorders entered the study. Baseline patients’ characteristics and the abovementioned inflammatory markers were collected, and arithmetical means with standard deviation, area under the curve (AUC), thresholds, sensitivity, specificity, positive(+)likelihood ratio (LR), and negative(−)LR with corresponding 95% confidence interval(95%CI) were calculated and correlated with presence or absence of SSI.

Results

Nine patients suffered from a SSI, whereas the remaining 89 patients had a recurrent/adjacent-segment degenerative disorder without evidence of infection. The most significant parameter for diagnosing a SSI was serum IL-6 (cut-off value > 15.3 pg/ml, AUC = 0.954, SE = 85.7%, SP = 97.3%), followed by CRP (cut-off value = 0.8 mg/dl, AUC = 0.916, SE = 88.9%, SP = 84.5%)

Conclusions

In the case of recurrent or new symptomatology following spinal surgery, serum IL-6 has the highest diagnostic potential for diagnosing spinal SSI.

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Funding

The study was not financially or materially supported by or any income was received from a commercial sponsor or the NIH, Wellcome Trust, HHMI, or other foundations requiring open access.

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Authors and Affiliations

  1. Neurosurgical Clinic, Clinic of the University of Munich (Ludwig Maximilians University), Campus Grosshadern, Marchioninistrasse 15, D-81377, Munich, Germany

    Markus Lenski, Joerg-Christian Tonn & Sebastian Siller

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  1. Markus Lenski
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  2. Joerg-Christian Tonn
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  3. Sebastian Siller
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Markus Lenski and Sebastian Siller. The first draft of the manuscript was written by Markus Lenski and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Markus Lenski.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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This article is part of the Topical Collection on Infection

Presentation at a conference: 71st annual meeting of the German society for neurosurgery 2020.

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Lenski, M., Tonn, JC. & Siller, S. Interleukin-6 as inflammatory marker of surgical site infection following spinal surgery. Acta Neurochir 163, 1583–1592 (2021). https://doi.org/10.1007/s00701-020-04628-8

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  • DOI: https://doi.org/10.1007/s00701-020-04628-8

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