Background: Sepsis is a common complication following pancreaticoduodenectomy (PD). The aim of this study was to evaluate the risk factors of sepsis based on serum inflammatory markers and clinical characteristics in patients who underwent PD.
Methods: A total of 138 patients were enrolled in this study and all patients underwent curative PD. Logistic regression analysis was performed to identify risk factors for post-operative sepsis. The patients' basic clinical features and inflammatory biomarkers including cytokines (IL-1, IL-2, IL-6, IL-8, IL-10 and tumour necrosis factor-α), procalcitonin, C-reactive protein and peripheral neutrophil to lymphocyte ratio were analysed.
Results: Of 138 patients, 31 developed sepsis during hospitalization. Univariate logistic regression analysis showed that body mass index, blood transfusion, operative time, American Society of Anesthesiologists score and diabetes were significant predictors of sepsis among all clinical characteristic variables. IL-2, IL-6, IL-10, procalcitonin and C-reactive protein were significant predictors among all inflammation biomarkers. By including different variables, three different regression models were obtained. The full model including all predictors mentioned above showed a C-index of 0.831 and blood transfusion showed no statistically significance in this model. The reduced model 1 including blood transfusion showed a C-index of 0.809. Another reduced model which included pre-operative and intra-operative variables showed a C-index of 0.814 and this model could be used for early sepsis risk estimation.
Conclusion: Pre-operative IL-6 was an independent risk factor for sepsis following PD. The three different predictive models could help early sepsis estimation for patients underwent PD.
Keywords: biomarker; multivariate analysis; pancreaticoduodenectomy; risk factor; sepsis.
© 2020 Royal Australasian College of Surgeons.