After surgery, approximately 3–22% of patients develop postoperative complications.[1–4] Once a complication develops, the patient's hospitalization is prolonged, worsening the prognosis. Previous studies have reported that white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), and presepsin (P-SEP) levels may be useful biomarkers for predicting postoperative complications.[5–13] However, standard biomarkers for predicting postoperative complications have not been established.
Histidine-rich glycoprotein (HRG) is an approximately 75-kDa glycoprotein mainly synthesized in the liver and present at a level of 60–150 μg/mL in healthy individuals.[14–17] HRG binds to various ligands and regulates coagulation fibrinolysis, the immune system, and angiogenesis.[17,18] In mice with sepsis, HRG levels decreased because of decreased production in the liver and increased degradation. Furthermore, decrease in HRG levels caused dysregulation of the coagulation-fibrinolysis system, abnormal neutrophil morphology, endothelial cell abnormalities, and immune thrombosis, leading to multiple organ failure.[17,19] Earlier clinical studies have reported that decrease in HRG levels may be a biomarker for sepsis,[16,20] ventilator-associated pneumonia, preeclampsia, and coronavirus disease 2019.
However, the usefulness of HRG in perioperative management remains unknown. We hypothesized that HRG levels on postoperative day 1 (POD 1) could predict postoperative complications and conducted a prospective observational study to assess the usefulness of HRG as a biomarker for predicting postoperative complications.
BMC Anesthesiol. 2022;22(232) © 2022 BioMed Central, Ltd.