The predictive role of delayed hypersensitivity in preoperative patients.

Seven hundred and twenty-seven surgical patients who were skin tested with recall antigens prior to operation were analyzed. The analysis included preoperative diagnosis, operative intervention, postoperative septic complications and death. The normal skin test responders were of similar age and had equal degrees of surgical procedures performed compared with patients who were anergic. Preoperatively, polymorphonuclear neutrophil chemotaxis was abnormal in the majority of anergic patients, as was the serum albumin concentration. Postoperatively, sepsis, mortality and death due to sepsis were significantly higher in the anergic population, reconfirming the hypothesis that skin test anergy in patients preoperatively is a signal of increased risk for septic complications and death in such patients.