Prospective analysis of inflammatory markers and perioperative clinical data in children with craniosynostosis undergoing reconstructive surgery

Bashiryan BA, Gadzhieva OA, Satanin LA, et al. . Prospective analysis of inflammatory markers and perioperative clinical data in children with craniosynostosis undergoing reconstructive surgery. Burdenko's Journal of Neurosurgery. 2024;88(1):70‑78. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248801170

Подписка 2025-2 (Burdenko's Journal of Neurosurgery)

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BACKGROUND

Craniosynostosis (CS) is a group of skull malformations manifested by congenital absence or premature closure of cranial sutures. Reconstructive surgery in the second half of life is traditional approach for CS. The issues of surgical stress response after reconstructive surgery for CS in children are still unclear.

OBJECTIVE

To evaluate clinical and laboratory parameters in children undergoing traumatic reconstructive surgery for CS.

MATERIAL AND METHODS

Inclusion criteria were CS, reconstructive surgery, age <24 months, no comorbidities and available laboratory diagnostic protocol including complete blood count, biochemical blood test with analysis of C-reactive protein, procalcitonin, ferritin and presepsin. The study included 32 patients (24 (75%) boys and 8 (25%) girls) aged 10.29±4.99 months after surgery between October 2021 and June 2022. Non-syndromic and syndromic forms of CS were observed in 25 (78.1%) and 7 (21.9%) cases, respectively.

RESULTS

There were no infectious complications. We analyzed postoperative clinical data, fever, clinical and biochemical markers of inflammation.

CONCLUSION

Early postoperative period after reconstructive surgery for CS in children is accompanied by significant increase of inflammatory markers (C-reactive protein, procalcitonin, ferritin). However, these findings do not indicate infectious complications. This is a manifestation of nonspecific systemic reaction. Severity of systemic inflammatory response syndrome with increase in acute phase proteins indicates highly traumatic reconstructive surgery for CS in children. Analysis of serum presepsin allows for differential diagnosis between infectious complication and uncomplicated course of early postoperative period.

Keywords:

craniosynostosis

reconstructive surgery

surgical stress response

markers of inflammation

presepsin

C-reactive protein

procalciotonin

ferritin

infectious complications

Authors:

Bashiryan B.A.

Burdenko National Medical Research Center of Neurosurgery

ORCID: 0000-0002-5559-2678

Gadzhieva O.A.

Burdenko Neurosurgery Center

ORCID: 0000-0002-9850-050X

Satanin L.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-2051-1855

Lavrenyuk E.A.

Burdenko Neurosurgical Center

ORCID: 0009-0004-8477-9564

Tere V.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-4247-8953

Mazerkina N.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0428-0498

Sakharov A.V.

Burdenko Neurosurgical Center

ORCID: 0000-0001-5119-6814

Getmanova I.V.

Burdenko Neurosurgical Center

ORCID: 0000-0001-8970-5303

Roginsky V.V.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0003-0549-855X

Received:

07.08.2023

Accepted:

17.11.2023

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