Postoperative changes in presepsin level and values predictive of surgical site infection after spinal surgery: A single-center, prospective observational study

Tomoaki Koakutsu, Tetsuya Sato, Toshimi Aizawa, Eiji Itoi, Shigeki Kushimoto

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Study Design. Single-institutional, prospective observational study. Objective. To elucidate the perioperative kinetics of presepsin (PSEP) in patients undergoing spinal surgery, and to evaluate the possibility of PSEP in the early diagnosis of surgical site infection (SSI). Summary of Background Data. Early diagnosis of SSI after spinal surgery is important. Although several biomarkers have been used as early indicators of SSI, the specificity of these markers in SSI diagnosis was not high. PSEP was found as a novel diagnostic marker for bacterial sepsis in 2004. However, its kinetics after spinal surgery and its usefulness in early diagnosis of SSI have never been evaluated. Methods. A total of 118 patients who underwent elective spinal surgery were enrolled. PSEP was measured before, immediately after, 1 day after, and 1 week after surgery. In patients without postoperative infection, perioperative kinetics of PSEP were analyzed. PSEP levels in patients with postoperative infection were also recorded separately, and their utility in SSI diagnosis was evaluated. Results. In the 115 patients without postoperative infection, the median PSEP value was 126, 171, 194, and 147 pg/mL before, immediately after, 1 day after, and 1 week after surgery, respectively. Compared with the preoperative value, PSEP was significantly higher immediately after surgery and the next day, and return to the preoperative level 1 week after surgery. The estimated reference value for 95 percentile in patients without postoperative infection was 297 pg/mL 1 week after surgery. In three patients with postoperative infection, higher levels (>300 pg/mL) were observed 1 week after surgery. Conclusion. In patients after spinal surgery without infectious complications, blood levels of PSEP may immediately increase and return to preoperative levels 1 week after surgery. The PSEP value of 300 pg/mL 1 week after surgery might be used as a novel indicator for suspected SSI.

Original languageEnglish
Pages (from-to)578-584
Number of pages7
JournalSpine
Volume43
Issue number8
DOIs
Publication statusPublished - 2018 Apr 15

Keywords

  • Biomarker
  • Complication
  • Early diagnosis
  • Infection
  • Kinetics
  • Presepsin
  • Soluble CD14-subtype
  • Spine
  • Surgery
  • Surgical wound infection

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Postoperative changes in presepsin level and values predictive of surgical site infection after spinal surgery: A single-center, prospective observational study'. Together they form a unique fingerprint.

  • Cite this