Biomarkers in the Early Detection of Surgical Complications

Abstract

Background: Postoperative complications such as surgical site infections, wound dehiscence, and sepsis continue to be major contributors to morbidity, extended hospital stays, and increased healthcare costs. Early detection remains a clinical challenge, often leading to delayed treatment. Biomarkers like C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) have shown potential in identifying complications before clinical signs become evident.

Aim: To evaluate the role of CRP, PCT, and IL-6 as early diagnostic biomarkers for detecting postoperative complications in patients undergoing major surgery.

Methods: A prospective observational study was conducted at Narayan Medical College and Hospital (NMCH), Jamuhar, involving 200 patients who underwent major surgical procedures. Blood samples were collected preoperatively and at 24 and 72 hours postoperatively to measure CRP, PCT, and IL-6 levels. Patients were monitored for postoperative complications. Data were analyzed using SPSS version 23.0, applying appropriate statistical tests including chi-square, t-test, and ROC curve analysis.

Results: Out of 200 patients, 48 (24%) developed complications, most commonly surgical site infections. Biomarker levels at 72 hours post-op were significantly higher in the complication group: CRP (>70 mg/L), PCT (>1.5 ng/mL), and IL-6 (>120 pg/mL) with p < 0.001 for all. ROC analysis showed that IL-6 had the highest diagnostic accuracy (AUC 0.928), followed by PCT (AUC 0.914) and CRP (AUC 0.871).

Conclusion: CRP, PCT, and IL-6 are effective early biomarkers for detecting postoperative complications, with IL-6 demonstrating the highest predictive value. These markers can aid in timely diagnosis and intervention, improving surgical outcomes.

Recommendations: Routine postoperative monitoring of IL-6 and PCT should be considered, especially in high-risk surgical patients. Further multicentric studies with larger samples are recommended to validate biomarker thresholds across diverse surgical populations.

Keywords: Biomarkers, Postoperative complications, IL-6, Procalcitonin, C-reactive protein