Sex, Type of Surgery, and Surgical Site Infections Are Associated with Perioperative Cortisol in Colorectal Cancer Patients

Figures

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  Figure 1. Plasma cortisol dynamics in early postoperative period following colorectal surgery. Data are presented as medians with 95% CI. Data were analyzed following log-transformation using repeated measures analysis of variance (n = 61). Significant differences between time points are indicated by symbols of the same type (*, #). CI, confidence interval; preop, preoperative; 8 h, 8 h post-incision; 24 h, 24 h post-incision; 72 h, 72 h post-incision.

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  Figure 2. Impact of various patient characteristics on plasma cortisol dynamics in early postoperative period following colorectal surgery: (a) sex; (b) age; (c) body mass; (d) health status. Data presented as medians with 95% CI. Data were analyzed following log-transformation using repeated measures analysis of variance with p values indicating significance of between-subjects (sex, age, body mass, and ASAPS) and within-subjects (time points) effects (n = 61). BMI, body mass index; yrs., years; ASAPS, the American Society of Anesthesiologists physical status classification system; CI, confidence interval; preop, preoperative; 8 h, 8 h post-incision; 24 h, 24 h post-incision; 72 h, 72 h post-incision.

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  Figure 3. Impact of surgery-related data on plasma cortisol dynamics in early postoperative period following colorectal surgery: (a) surgery type; (b) estimated blood loss; (c) number of harvested lymph nodes; (d) length of surgery. Data presented as medians with 95% CI. Data were analyzed following log-transformation using repeated measures analysis of variance with p values indicating significance of between-subjects (surgery type, extent, length, and EBL) and within-subjects (time points) effects (n = 61). EBL, estimated blood loss; LN, lymph nodes; CI, confidence interval; preop, preoperative; 8 h, 8 h post-incision; 24 h, 24 h post-incision; 72 h, 72 h post-incision.

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  Figure 4. Predictive power of combined assessment of cortisol and C-reactive protein (CRP) as surgical site infection (SSI) marker. Determination of cortisol change at 24 h post-incision adjusted to baseline concentration (Δ24/0) was combined with CRP quantification at 72 h post-incision. Data presented as receiver operating characteristics (ROC) curve. AUC, area under ROC curve representative of marker accuracy with 95% confidence interval. Closed orange circle indicates an optimal cut-off corresponding with the highest combined sensitivity and specificity.