The application of Peripheral blood lymphocyte in early diagnosis of spinal postoperative surgical site infection

English Keywords:Cervical surgery  Surgical site infection  Lymphocytes

English Abstract:

  【Abstract】 Objectives: To explore the early diagnostic value of peripheral blood lymphocyte in evaluating cervical SSI. Methods: A total of 18 patients with cervical SSI(from Huashan hospital of Fudan university, 2001.1-2015.10) and age-and height-match 47 patients without SSI were analyzed retrospectively in this study. All patients were retrospectively analyzed white blood cells, neutrophils, lymphocytes, erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) before operation and 3 days after surgery. Receiver operating characteristic curve(ROC) of the above-mentioned parameters in postoperative 3 days was analyzed, and the area under curve(AUC) was measured. Furthermore, the critical value of each measurements was measured by using Youden index. All data were analyzed by SPSS 12.0. Results: Preoperatively, only lymphocytes in deep SSI patient group decreased significantly compared to the patients without SSI(P=0.01). Postoperatively, the lymphocytes of both superficial and deep SSI were significantly lower than those of the patients without SSI(P=0.02). In addition, compared to those without SSI, only CRP and ESR in the patients with deep SSI were demonstrated to be abnormally increased(P=0.00). According to ROC curve, both CRP(P=0.01) and lymphocytes(P=0.00) had significant diagnosis value in evaluating cervical SSI(P<0.05). Compared to the AUC(0.71) of CRP, lymphocytes had relatively larger AUC(0.97), and Youden index of lymphocytes(0.944; critical value 1.31×109/L) was also larger than that of CRP(0.424; critical value 14.7mg/L). Conclusions: There was a close relationship between abnormal changes of lymphocytes and the occurrence of spinal postoperative SSI. Early postoperative observation of abnormal degree in the peripheral blood lymphocytes can effectively predicting the occurrence of SSI.