C-Reactive Protein Is an Early Predictor of Septic Complications After Elective Colorectal Surgery View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2010-01-05

AUTHORS

Pablo Ortega-Deballon, François Radais, Olivier Facy, Philippe d’Athis, David Masson, Pierre E. Charles, Nicolas Cheynel, Jean-Pierre Favre, Patrick Rat

ABSTRACT

BackgroundNowadays, most patients who undergo colorectal surgery are discharged early. An early predictor of septic complications could avoid readmissions and decrease morbidity. CRP could be a good predictor allowing a safe discharge.MethodsA prospective, observational study was conducted from November 2007 to October 2008. All patients who underwent elective colorectal surgery were included. Clinical (temperature, pulse, abdominal tenderness, bowel movements) and laboratory data (C-reactive protein, leukocyte count) were recorded and evaluated as early predictors of septic complications (namely, anastomotic leaks). All detected leaks were considered fistulas, independently of their clinical significance. Clinical and inflammatory parameters were analyzed with univariate and multivariate techniques; logistic regression was performed and areas under the receiver operating characteristic curve were compared.ResultsA total of 133 patients were included. The overall incidence of anastomotic leaks was 15.5% and mortality was 4.5%. C-reactive protein at postoperative days 2 and 4 was a good predictor of anastomotic leak (areas under the curve were 0.715 and 0.845, respectively) and other postoperative septic complications (areas under the curve were 0.804 and 0.787), showing the highest accuracy among clinical and laboratory data. A cutoff of 125 mg/l in the level of C-reactive protein at postoperative day 4 yielded a sensitivity of 81.8% and a negative predictive value of 95.8% for the detection of anastomotic leakage.ConclusionsC-reactive protein is a simple way to ensure a safe discharge from hospital after elective colorectal surgery. Patients with CRP values >125 mg/l on the fourth postoperative day should not be discharged. More... »

PAGES

808-814

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-009-0367-x

DOI

http://dx.doi.org/10.1007/s00268-009-0367-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039023994

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20049435


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53 data
54 day 2
55 day 4
56 days
57 decrease morbidity
58 detection
59 discharge
60 early predictor
61 elective colorectal surgery
62 fistula
63 fourth postoperative day
64 high accuracy
65 hospital
66 incidence
67 inflammatory parameters
68 laboratory data
69 leak
70 leakage
71 levels
72 logistic regression
73 morbidity
74 mortality
75 most patients
76 multivariate techniques
77 negative predictive value
78 observational study
79 overall incidence
80 parameters
81 patients
82 postoperative day
83 postoperative day 2
84 postoperative day 4
85 postoperative septic complications
86 predictive value
87 predictors
88 protein
89 reactive protein
90 readmission
91 receiver
92 regression
93 safe discharge
94 sensitivity
95 septic complications
96 significance
97 simple way
98 study
99 surgery
100 technique
101 total
102 univariate
103 values
104 way
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