背景:术后脊柱感染(PSI)的发生率为0%至10%,由于较高的发病率,毁灭性地影响了患者的预后,并增加了医疗保健系统的成本。术后脊柱感染需要高度怀疑,因为它们很难诊断,尤其是在术后早期,由于许多混杂因素,如临床症状,血清生物标志物升高或混淆影像学研究。目前的研究集中在疾病早期的血清生物标志物,然而,大多数人依赖于单独和在不同时间点研究血清生物标志物的回顾性队列.
目的:确定选择性脊柱退行性手术患者的炎症生物标志物行为特征及其与术后脊柱感染患者的差异。
方法:建议的系统审查将遵循PRISMA声明。该协议于1月19日在PROSPERO注册,2022年2月19日获得以下注册CRD42022304645,2022年。我们将包括与因退行性脊柱疾病而接受手术的成年患者的生物标志物相关的研究,以及术后脊髓感染的患者.将提取以下信息:(1)研究标题;(2)研究作者(3)年;(4)证据水平;(5)研究类型;(6)诊断组(选择性术后退行性疾病/PSI);(7a)区域(宫颈,胸科,腰骶部,Coccirecal);(7b)解剖或放射学部位的感染类型,(8)手术类型(包括器械或非器械);(9)病例数;(10)平均年龄或个体年龄;(11)两组的术前状态直至90天的个体血清生物标志物值,包括:(10a)白细胞介素6,(10b)Presepsine,(10c)红细胞沉降率,(10d)白细胞计数,(10e)中性粒细胞计数,(10f)C反应蛋白,(10g)血清淀粉样蛋白,(10h)白细胞计数,(10i)白蛋白,(10j)前白蛋白,(10k)降钙素原,(10L)视黄醇相关蛋白,(10M)Dickopf-1,(11)症状或诊断后的术后天数,(12)生物体的类型,(13)开始使用抗生素的一天,(14)治疗持续时间和(15)任何偏见(包括合并症,尤其是那些影响免疫状态的人)。所有生物标志物数据将随时间以图形方式呈现。图1包含方法的流程图。
结果:不需要道德批准,因为本综述基于已发表的数据,不涉及与人类参与者的互动。这项系统评价的搜索始于2021年2月,我们预计将在2023年中期发布调查结果。
结论:本研究将提供PSI和退行性脊柱疾病择期手术后患者的生物标志物行为概况,从术前到术后90天提供诊断当天的临界值。它将为临床医生提供更好的背景,以根据此系统评价的截止值基于高度可信的信息进行诊断。最后,我们希望这篇综述能够为未来生物标志物的研究提供基础,以建立更准确和及时的诊断在疾病的早期阶段,最终影响患者的身心健康。减轻疾病负担。
背景:PROSPERO寄存器ID:CRD42022304645。
BACKGROUND: The incidence of postoperative spinal infection (PSI) ranges from 0% to 10%, with devastating effects on the patient prognosis because of higher morbidity while increasing costs to the health care system. PSIs are elusive and difficult to diagnose, especially in the early postoperative state, because of confusing clinical symptoms, rise in serum biomarkers, or imaging studies. Current research on diagnosis has focused on serum biomarkers; nevertheless, most series rely on retrospective cohorts where biomarkers are studied individually and at different time points.
OBJECTIVE: This paper presents the protocol for a systematic review that aims to determine the inflammatory biomarker behavior profile of patients following elective degenerative spine surgery and their differences compared to those coursing with PSIs.
METHODS: The proposed systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. This protocol was registered at PROSPERO on January 19, 2022. We will include studies related to biomarkers in adult patients operated on for degenerative spinal diseases and those developing PSIs. The following information will be extracted from the papers: (1) study title; (2) study author; (3) year; (4) evidence level; (5) research type; (6) diagnosis group (elective postoperative degenerative disease or PSI); (7a) region (cervical, thoracic, lumbosacral, and coccygeal); (7b) type of infection by anatomical or radiological site; (8) surgery type (including instrumentation or not); (9) number of cases; (10) mean age or individual age; (11) individual serum biomarker values from the preoperative state up to 90 days postoperative for both groups, including (10a) interleukin-6, (10b) presepsin, (10c) erythrocyte sedimentation rate, (10d) leukocyte count, (10e) neutrophil count, (10f) C-reactive protein, (10g) serum amyloid, (10h) white cell count, (10i) albumin, (10j) prealbumin, (10k) procalcitonin, (10l) retinol-associated protein, and (10m) Dickkopf-1; (11) postoperative days at symptoms or diagnosis; (12) type of organism; (13) day of starting antibiotics; (14) duration of treatment; and (15) any biases (including comorbidities, especially those affecting immunological status). All data on biomarkers will be presented graphically over time.
RESULTS: No ethical approval will be required, as this review is based on published data and does not involve interaction with human participants. The search for this systematic review commenced in February 2021, and we expect to publish the findings in mid-2023.
CONCLUSIONS: This study will provide the behavior profile of biomarkers for PSI and patients following elective surgery for degenerative spinal diseases from the preoperative period up to 90 days postoperative, providing cutoff values on the day of diagnosis. This research will provide clinicians with highly trustable cutoff reference values for PSI diagnosis. Finally, we expect to provide a basis for future research on biomarkers that help diagnose more accurately and in a timely manner in the early stages of illness, ultimately impacting the patient\'s physical and mental health, and reducing the disease burden.
BACKGROUND: PROSPERO CRD42022304645; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=304645.
UNASSIGNED: DERR1-10.2196/41555.