Inflammatory Genetic Biomarkers as Predictors of Clinical Evolution and Postoperative Pain in Patients with Early Medical Care

Abstract

Background: Postoperative pain and clinical evolution after surgery show substantial interindividual variability, even under standardized early medical care protocols. Genetic inflammatory biomarkers have emerged as potential predictors of postoperative outcomes, supporting the development of personalized medicine approaches in surgical care. Objective: To analyze the predictive value of inflammatory genetic biomarkers on postoperative pain and clinical evolution in patients receiving early medical care. Methods: A quantitative, observational, longitudinal, and predictive study was conducted in 210 adult surgical patients managed under early medical care protocols. Preoperative genotyping of inflammatory polymorphisms (IL6 rs1800795, IL1B rs16944, TNF rs1800629, IL10 rs1800896, and CRP rs1205) was performed using real-time PCR. Postoperative pain was assessed using the Visual Analog Scale at 24, 48, and 72 hours. Clinical evolution was evaluated through hospital stay duration and postoperative complications. Multivariate linear and logistic regression models were applied. Results: Proinflammatory genotypes of IL6 and IL1B were significantly associated with higher postoperative pain intensity (p < 0.01). Variants of TNF and CRP were independent predictors of unfavorable clinical evolution, increasing the risk of postoperative complications (OR = 2.31 and OR = 2.67, respectively). Predictive models integrating genetic and clinical variables demonstrated superior explanatory capacity compared to clinical models alone. Conclusions: Inflammatory genetic biomarkers are significant predictors of postoperative pain and clinical evolution, even in the context of early medical care. Their integration into preoperative assessment may enhance risk stratification and support personalized perioperative management strategies.