OBJECTIVE: To investigate the kinetics of interleukin-6 (IL-6), leucocyte elastase complex (elastase), C-reactive protein (CRP), and total white blood cell count (WBC) after open appendicectomy. DESIGN: Prospective study. SETTING: Teaching hospital, Sweden. SUBJECTS: 21 patients with suspected acute appendicitis who underwent appendicectomy. INTERVENTIONS: Serum samples were taken preoperatively and postoperatively on days 1, 2, 6, 10, and 30. MAIN OUTCOME MEASURES: Changes in IL-6, elastase, and CRP concentrations and WBC postoperatively, and their correlation with complications. RESULTS: The highest IL-6 concentrations and WBC were found preoperatively, while postoperatively elastase peaked on day 1, and CRP on day 2. One patient developed a suspected deep infection resulting in secondary peaks of IL-6, WBC, and CRP on day 6. Two patients with perforated appendicitis had high preoperative values of IL-6, elastase, and CRP. CONCLUSIONS: Concentrations of IL-6, elastase, and CRP, and WBC increase after surgical trauma, and can remain high for up to 10 days. It is important to understand the postoperative kinetics for each test. Postoperative complications might best be detected by measuring IL-6 and CRP concentrations, and WBC.
OBJECTIVE: To investigate the kinetics of interleukin-6 (IL-6), leucocyte elastase complex (elastase), C-reactive protein (CRP), and total white blood cell count (WBC) after open appendicectomy. DESIGN: Prospective study. SETTING: Teaching hospital, Sweden. SUBJECTS: 21 patients with suspected acute appendicitis who underwent appendicectomy. INTERVENTIONS: Serum samples were taken preoperatively and postoperatively on days 1, 2, 6, 10, and 30. MAIN OUTCOME MEASURES: Changes in IL-6, elastase, and CRP concentrations and WBC postoperatively, and their correlation with complications. RESULTS: The highest IL-6 concentrations and WBC were found preoperatively, while postoperatively elastase peaked on day 1, and CRP on day 2. One patient developed a suspected deep infection resulting in secondary peaks of IL-6, WBC, and CRP on day 6. Two patients with perforated appendicitis had high preoperative values of IL-6, elastase, and CRP. CONCLUSIONS: Concentrations of IL-6, elastase, and CRP, and WBC increase after surgical trauma, and can remain high for up to 10 days. It is important to understand the postoperative kinetics for each test. Postoperative complications might best be detected by measuring IL-6 and CRP concentrations, and WBC.
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