Determining the normative reference values for acute-phase inflammatory markers 3 days after lumbar fusion surgery by using the e-norms method

IF 4.9 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2024-11-28 DOI:10.1016/j.spinee.2024.11.016

Shenyan Gu BS , Kaiwen Chen BS , Dongqing Zhu MD , Feizhou Lyu MD , Jianyuan Jiang MD , Xinlei Xia MD , Joe F. Jabre MD , Chaojun Zheng MD

{"title":"Determining the normative reference values for acute-phase inflammatory markers 3 days after lumbar fusion surgery by using the e-norms method","authors":"Shenyan Gu BS , Kaiwen Chen BS , Dongqing Zhu MD , Feizhou Lyu MD , Jianyuan Jiang MD , Xinlei Xia MD , Joe F. Jabre MD , Chaojun Zheng MD","doi":"10.1016/j.spinee.2024.11.016","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Surgical site infection (SSI) is a devastating complication that greatly increases the duration of hospital stays, health care costs and morbidity/mortality rates. Therefore, early diagnosis and treatment are also very important. Postoperative inflammatory markers are usually used to screen for SSI. However, the feasibility of these markers for the early detection of SSI remains unclear since it is not ideal to use a marker for which normative reference values do not exist.</div></div><div><h3>PURPOSE</h3><div>To validate the use of the e-norms method for establishing a normative reference range for acute-phase inflammatory marker levels 3 days after lumbar fusion surgery for early screening of postoperative SSI.</div></div><div><h3>STUDY DESIGN</h3><div>A retrospective analysis.</div></div><div><h3>PATIENT SAMPLE</h3><div>This study included 907 patients who underwent lumbar fusion surgery (SSI vs non-SSI: 28 vs 879).</div></div><div><h3>OUTCOME MEASURES</h3><div>White blood cell (WBC) count, neutrophils count, lymphocyte count, C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR).</div></div><div><h3>METHODS</h3><div>We applied the e-norms method to calculate reference values for postoperative 3-day CRP, ESR, and differential WBC count in all 907 patients included in this study and compared these reference values with those calculated via conventional methods (data from non-SSI patients).</div></div><div><h3>RESULTS</h3><div>According to the e-norms method, the normal WBC count was 10.8±1.2 (x10^9/L), neutrophils count was 8.7±1.1 (x10^9/L), lymphocyte count was 1.6±0.3 (x10^9/L), CRP concentration was 31.2±10.8 mg/L, and ESR was 23.6±4.7 mm/h. The mean values obtained via the e-norms and conventional methods were almost identical, but the range of normative reference values obtained via the conventional methods was relatively wider. Importantly, the frequency of SSI patients with abnormal inflammatory markers identified by the e-norms method was higher than that of patients with abnormal inflammatory markers identified by the conventional methods (21/28, 75.0% vs 6/28, 21.4%; p<.05).</div></div><div><h3>CONCLUSIONS</h3><div>The results of this study demonstrated that the reference values retrieved using e-norms were more effective for screening postoperative SSI than the reference values calculated using conventional methods. Thus, e-norms may be an alternative reliable and time-saving approach to establishing reference values for acute-phase inflammatory markers after spinal surgery.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Pages 649-657"},"PeriodicalIF":4.9000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1529943024011586","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

BACKGROUND CONTEXT

Surgical site infection (SSI) is a devastating complication that greatly increases the duration of hospital stays, health care costs and morbidity/mortality rates. Therefore, early diagnosis and treatment are also very important. Postoperative inflammatory markers are usually used to screen for SSI. However, the feasibility of these markers for the early detection of SSI remains unclear since it is not ideal to use a marker for which normative reference values do not exist.

PURPOSE

To validate the use of the e-norms method for establishing a normative reference range for acute-phase inflammatory marker levels 3 days after lumbar fusion surgery for early screening of postoperative SSI.

STUDY DESIGN

A retrospective analysis.

PATIENT SAMPLE

This study included 907 patients who underwent lumbar fusion surgery (SSI vs non-SSI: 28 vs 879).

OUTCOME MEASURES

White blood cell (WBC) count, neutrophils count, lymphocyte count, C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR).

METHODS

We applied the e-norms method to calculate reference values for postoperative 3-day CRP, ESR, and differential WBC count in all 907 patients included in this study and compared these reference values with those calculated via conventional methods (data from non-SSI patients).

RESULTS

According to the e-norms method, the normal WBC count was 10.8±1.2 (x10^9/L), neutrophils count was 8.7±1.1 (x10^9/L), lymphocyte count was 1.6±0.3 (x10^9/L), CRP concentration was 31.2±10.8 mg/L, and ESR was 23.6±4.7 mm/h. The mean values obtained via the e-norms and conventional methods were almost identical, but the range of normative reference values obtained via the conventional methods was relatively wider. Importantly, the frequency of SSI patients with abnormal inflammatory markers identified by the e-norms method was higher than that of patients with abnormal inflammatory markers identified by the conventional methods (21/28, 75.0% vs 6/28, 21.4%; p<.05).

CONCLUSIONS

The results of this study demonstrated that the reference values retrieved using e-norms were more effective for screening postoperative SSI than the reference values calculated using conventional methods. Thus, e-norms may be an alternative reliable and time-saving approach to establishing reference values for acute-phase inflammatory markers after spinal surgery.

查看原文本刊更多论文

采用e-norm法测定腰椎融合术后3天急性期炎症指标的规范参考值。

背景背景：手术部位感染（SSI）是一种毁灭性的并发症，它大大增加了住院时间、医疗费用和发病率/死亡率。因此，早期诊断和治疗也非常重要。术后炎症标志物通常用于SSI筛查。然而，这些标记物用于SSI早期检测的可行性尚不清楚，因为使用不存在规范参考值的标记物并不理想。目的：验证e-norm方法在腰椎融合术后3天急性期炎症标志物水平建立规范参考范围，用于早期筛查术后SSI。研究设计：回顾性分析患者样本：该研究包括907例接受腰椎融合术的患者（SSI与非SSI: 28对879）。结果测量：白细胞（WBC）计数、中性粒细胞计数、淋巴细胞计数、c反应蛋白（CRP）和红细胞沉降率（ESR）方法：我们应用e-规范法计算纳入本研究的907例患者术后3天CRP、ESR和差异WBC计数的参考值，并将这些参考值与常规方法计算的参考值（数据来自非ssi患者）进行比较。结果：根据e-norm法，正常WBC计数10.8±1.2 (x10^9/L)，中性粒细胞计数8.7±1.1 (x10^9/L)，淋巴细胞计数1.6±0.3 (x10^9/L)， CRP浓度31.2±10.8 mg/L, ESR 23.6±4.7 mm/h。电子规范与常规方法得到的平均值几乎相同，但常规方法得到的规范参考值范围相对较宽。重要的是，通过e-norm方法识别炎症标志物异常的SSI患者的频率高于常规方法识别炎症标志物异常的患者(21/28,75.0% vs. 6/28, 21.4%；结论：本研究结果表明，使用e规范检索的参考值比使用常规方法计算的参考值更有效地筛查术后SSI。因此，e-norm可能是另一种可靠且节省时间的方法来建立脊柱手术后急性期炎症标志物的参考值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.