Soluble Urokinase Receptor Levels Are Not Affected by the Systemic Inflammatory Response to Anesthesia and Operative Trauma

Introduction: Soluble urokinase plasminogen activator receptor (suPAR) is an emerging biomarker of the level of chronic systemic inflammation and the general condition of the patient. We aimed to investigate the impact of general anesthesia and major surgery on perioperative suPAR and C-reactive protein (CRP) levels. Methods: This study included patients undergoing elective major noncardiac surgery with an expected duration of >= 2 h under general anesthesia. Inclusion criteria were age >= 18 years and American Society of Anesthesiologists' physical status I-IV. Blood was drawn 30 min prior to induction of anesthesia (preoperatively), as well as 30 min after emergence from anesthesia (postoperatively). Plasma suPAR levels were determined using the suPARnostic (R) Quick Triage lateral flow assay. CRP measurements were performed by particle-enhanced immunoturbidimetric assay. Results: The difference in preoperative and postoperative suPAR levels was not statistically significant (7.7 [5.28-10.4] ng/mL vs. 7.15 [5.68-9.8] ng/mL, p = 0.462). CRP levels increased significantly during surgery (0.81 [0.24-2.1] mg/dL vs. 5.76 [2.2-8.75] mg/dL, p < 0.001). No correlation was observed between CRP and suPAR levels, both preoperatively (rho = 0.127; p = 0.208) and postoperatively (rho = 0.017; p = 0.87). A statistically significant increase was also observed in postoperative white blood cell count (7.576 vs. 10.711, p < 0.001). Conclusion: General anesthesia and operative trauma did not affect perioperative suPAR levels despite the activation of systemic inflammatory response.

Automated summary

This study investigated the impact of general anesthesia and major surgery on perioperative levels of soluble urokinase plasminogen activator receptor (suPAR) and C-reactive protein (CRP). The results showed no significant difference in suPAR levels before and after surgery, while CRP levels increased significantly during surgery. There was no correlation between CRP and suPAR levels. In conclusion, despite the activation of systemic inflammatory response, general anesthesia and operative trauma did not affect perioperative suPAR levels.