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ORIGINAL RESEARCH article

Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1379410
This article is part of the Research Topic Newest Challenges and Advances in the Treatment of Colorectal Disorders; From Predictive Biomarkers to Minimally Invasive Techniques View all 22 articles

Butyrylcholinesterase (BChE) levels correlate with Surgical Site Infection Risk and Severity after Colorectal Surgery: A Prospective Single-Center Study

Provisionally accepted
Georgios-Ioannis Verras Georgios-Ioannis Verras 1Francesk Mulita Francesk Mulita 2*
  • 1 Epsom and St Helier University Hospitals NHS Trust, Carshalton, United Kingdom
  • 2 General University Hospital of Patras, Pátrai, Greece

The final, formatted version of the article will be published soon.

    Introduction: Surgical site infections (SSI) after colorectal surgery remains a devastating event, which warrants effective predictive markers for prompt diagnosis and treatment. Butyrylcholinesterase (BChE), a non-specific cholinesterase enzyme has been correlated with risk for hepatic dysfunction progression, and more recently infectious diseases, septic shock with ongoing research into the utility of BChE in multiple systemic inflammatory conditions. Whether these preliminary results can be translated in predicting infection after colorectal surgery remains in remains in question. This prospective study aimed to assess BChE's utility as a potential prediction marker for surgical site infections, and anastomotic leak, after colorectal surgery. Materials and Methods: This single-center prospective study (11/2019-05/2023) enrolled 402 patients who underwent colorectal surgery. BChE levels were measured at four postoperative time points. Primary endpoints focused on BChE's association in complications, particularly surgical site infections (SSI).Further known predictors of SSI were utilized in order to construct multivariable models to assess for independent association with SSI development. Results: During the 3 rd and 5 th day post-surgery, SSI patients had significantly lower mean BChE levels (3.90 KU/L vs. 4.54 KU/Lp-value <0.05;, and 4.14 KU/L vs. 4.73 KU/L, p-value <0.05; t-test, respectively). However, multivariate analysis revealed that when adjusted for other factors, low BChE levels on the 1 st postoperative day were associated with 2.6 times higher odds for developing SSI (OR: 2.6,).Similar results were found for low BChE levels on the 3 rd postoperative day as they were associated with a. 2.53 times higher odds for developing SSI (OR: 2.5, 95%CI: 1.27-3.87, p-value<0.05) when adjusted for other factors. Conclusion: In conclusion, in this prospective observational study low levels in the 1 st and 3 rd post-surgery were associated with an increased risk for the development of SSIs but not sepsis.

    Keywords: butyruylcholinesterase1, inflammation2, prediction3, surgical site infection4, colorectal surgery5

    Received: 31 Jan 2024; Accepted: 30 Jul 2024.

    Copyright: © 2024 Verras and Mulita. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Francesk Mulita, General University Hospital of Patras, Pátrai, Greece

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