Role of Inflammatory Cytokines (IL-6, TNF-α) in Predicting Outcomes after Major Abdominal Surgery
DOI:
https://doi.org/10.53350/pjmhs02026203.6Keywords:
Interleukin-6; Tumor Necrosis Factor-alpha; Abdominal Surgery; Postoperative Complications; Surgical Site Infection; Inflammatory Biomarkers.Abstract
Background: Major abdominal surgery is frequently associated with postoperative inflammatory activation, which may contribute to adverse clinical outcomes. Early identification of high-risk patients remains an important challenge in perioperative care. Inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) may serve as useful biomarkers for predicting postoperative morbidity and recovery.
Objective: To evaluate the role of IL-6 and TNF-α in predicting postoperative outcomes after major abdominal surgery.
Methodology: This prospective observational study was conducted from January 2023 to February 2025 in the Department of Pathology, Sharif Medical & Dental College, Lahore, a tertiary care teaching hospital. A total of 150 adult patients undergoing major abdominal surgery were enrolled through consecutive sampling. Serum IL-6 and TNF-α levels were measured preoperatively and at 24 hours postoperatively using enzyme-linked immunosorbent assay. Postoperative outcomes including surgical site infection, sepsis, ICU admission, prolonged hospital stay, and mortality were recorded and analyzed in relation to cytokine levels.
Results: There were 56 (37.3%) developed postoperative complications. Patients with complications had significantly higher postoperative IL-6 (487.5±122.8 pg/mL) and TNF-α (71.8±19.4 pg/mL) levels compared with patients without complications, who had mean postoperative IL-6 and TNF-α levels of 286.2±94.5 pg/mL and 43.6±15.7 pg/mL, respectively (p<0.001). Elevated cytokine levels were significantly associated with surgical site infection, postoperative sepsis, ICU admission, prolonged hospital stay, and mortality. IL-6 demonstrated a stronger predictive relationship with adverse postoperative outcomes than TNF-α.
Conclusion: Elevated perioperative IL-6 and TNF-α levels are significantly associated with poor postoperative outcomes after major abdominal surgery. IL-6, in particular, may serve as a valuable early biomarker for postoperative risk stratification and clinical monitoring.
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