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1.
Asian Spine Journal ; : 220-225, 2016.
Artigo em Inglês | WPRIM | ID: wpr-132118

RESUMO

STUDY DESIGN: Case-control study. PURPOSE: To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). OVERVIEW OF LITERATURE: SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. METHODS: We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and specificity of six laboratory markers for early detection of SSI were calculated: greater elevation of the white blood cell count at day 7 than at day 4 postoperatively, greater elevation of the C-reactive protein (CRP) level at day 7 than at day 4 postoperatively, a CRP level of >10 mg/dL at 4 days postoperatively, neutrophil percentage of >75% at 4 days postoperatively, a lymphocyte percentage of 10 mg/dL at 4 days postoperatively would be useful for definitive diagnosis of SSI, and a lymphocyte count of <1,000/µL at 4 days postoperatively would be a useful screening test for SSI. Although laboratory markers for early detection of SSI have been frequently reported, we believe that it is important to understand the characteristics of each index for a precise diagnosis.


Assuntos
Humanos , Biomarcadores , Proteína C-Reativa , Estudos de Casos e Controles , Diagnóstico , Diagnóstico Precoce , Contagem de Leucócitos , Contagem de Linfócitos , Linfócitos , Linfopenia , Programas de Rastreamento , Neutrófilos , Estudos Retrospectivos , Sensibilidade e Especificidade , Coluna Vertebral
2.
Asian Spine Journal ; : 220-225, 2016.
Artigo em Inglês | WPRIM | ID: wpr-132115

RESUMO

STUDY DESIGN: Case-control study. PURPOSE: To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). OVERVIEW OF LITERATURE: SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. METHODS: We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and specificity of six laboratory markers for early detection of SSI were calculated: greater elevation of the white blood cell count at day 7 than at day 4 postoperatively, greater elevation of the C-reactive protein (CRP) level at day 7 than at day 4 postoperatively, a CRP level of >10 mg/dL at 4 days postoperatively, neutrophil percentage of >75% at 4 days postoperatively, a lymphocyte percentage of 10 mg/dL at 4 days postoperatively would be useful for definitive diagnosis of SSI, and a lymphocyte count of <1,000/µL at 4 days postoperatively would be a useful screening test for SSI. Although laboratory markers for early detection of SSI have been frequently reported, we believe that it is important to understand the characteristics of each index for a precise diagnosis.


Assuntos
Humanos , Biomarcadores , Proteína C-Reativa , Estudos de Casos e Controles , Diagnóstico , Diagnóstico Precoce , Contagem de Leucócitos , Contagem de Linfócitos , Linfócitos , Linfopenia , Programas de Rastreamento , Neutrófilos , Estudos Retrospectivos , Sensibilidade e Especificidade , Coluna Vertebral
3.
Asian Spine Journal ; : 1042-1046, 2016.
Artigo em Inglês | WPRIM | ID: wpr-116276

RESUMO

STUDY DESIGN: Case control study. PURPOSE: To identify the most significant laboratory marker for early detection of surgical site infection (SSI) using multiple logistic regression analysis. OVERVIEW OF LITERATURE: SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial. METHODS: We retrospectively reviewed the laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spinal disease from January 2003 to December 2014. Six laboratory markers for early SSI detection were considered: renewed elevation of the white blood cell count, higher at 7 than 4 days postoperatively; renewed elevation of the C-reactive protein (CRP) level, higher at 7 than 4 days postoperatively; CRP level of >10 mg/dL at 4 days postoperatively; neutrophil percentage of >75% at 4 days postoperatively; lymphocyte percentage of <10% at 4 days postoperatively; and lymphocyte count of <1,000/µL at 4 days postoperatively. RESULTS: Ninety patients were enrolled; five developed deep SSI. Multivariate regression analysis showed that a lymphocyte count of <1,000/µL at 4 days postoperatively was the sole significant independent laboratory marker for early detection of SSI (p=0.037; odds ratio, 11.9; 95% confidence interval, 1.2–122.7). CONCLUSIONS: A lymphocyte count of <1,000/µL at 4 days postoperatively is the most significant laboratory marker for early detection of SSI.


Assuntos
Humanos , Biomarcadores , Proteína C-Reativa , Estudos de Casos e Controles , Diagnóstico Precoce , Contagem de Leucócitos , Leucócitos , Modelos Logísticos , Contagem de Linfócitos , Linfócitos , Linfopenia , Neutrófilos , Razão de Chances , Estudos Retrospectivos , Doenças da Coluna Vertebral , Infecção da Ferida Cirúrgica
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