Is there an association between inflammatory biomarkers and organ space surgical site infection after emergency laparotomy in massively transfused trauma patients?

Stephanie Martinez Ugarte; Mokunfayo O Fajemisin; Chelsea J Guy-Frank; James M Klugh; Xu Zhang; Erin E Fox; Charles E Wade; Kimberly A Mankiewicz; Lillian S Kao

doi:10.1016/j.amjsurg.2024.116106

Is there an association between inflammatory biomarkers and organ space surgical site infection after emergency laparotomy in massively transfused trauma patients?

Am J Surg. 2024 Nov 19:244:116106. doi: 10.1016/j.amjsurg.2024.116106. Online ahead of print.

Authors

Stephanie Martinez Ugarte¹, Mokunfayo O Fajemisin¹, Chelsea J Guy-Frank², James M Klugh², Xu Zhang³, Erin E Fox¹, Charles E Wade¹, Kimberly A Mankiewicz⁴, Lillian S Kao⁵

Affiliations

¹ Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
² Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
³ Center for Clinical and Translational Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
⁴ Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
⁵ Department of Surgery, Division of Acute Care Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA. Electronic address: [email protected].

PMID: 39615438
DOI: 10.1016/j.amjsurg.2024.116106

Abstract

Background: The relationship between inflammatory biomarkers (IB) and organ space surgical site infections (OS-SSIs) after emergency laparotomy (EL) is poorly understood.

Methods: Retrospective, single-center analysis of patients in the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial who underwent EL and survived 48 h after admission was performed. IB levels of IL-6, IL-8, G-CSF, MCP-1, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio were analyzed. IB and OS-SSIs association was evaluated using the Wilcoxon rank sum test.

Results: Of 74 eligible patients, 80 % were male, 69 % sustained blunt trauma, the injury severity score was 31 (24-41), and 22 % developed OS-SSIs. Levels of IL-6 (12, 24 h), IL-8 (2, 12, 24, 72 h), and MCP-1 (24 h) were higher in OS-SSI patients (P < 0.05).

Conclusions: IL-6, IL-8, and MCP-1 levels were associated with OS-SSIs in PROPPR patients who underwent EL. The IB may help to predict high-risk patients for OS-SSIs.