Meta-analysis of the predictive value of C-reactive protein for infectious complications in abdominal surgery

Adamina, Michel; Steffen, Thomas; Tarantino, Ignazio; Beutner, Ulrich; Schmied, Bruno M.; Warschkow, René

doi:10.1002/bjs.9756

Cited by 109 publications

(70 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some meta-analyses show that the CRP concentration on POD3-5 is a useful negative predictive test rather than a good positive predictor [20,21]. We confirmed this observation in our cohort study.…”

Section: Discussionsupporting

confidence: 89%

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Mik¹,

Dziki²,

Berut³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

Purpose: To assess the prognostic value of postoperative C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in the development of anastomotic leak (AL) in patients after surgery for colorectal cancer (CRC). Methods: Patients operated on for CRC between 2010 and 2014 were enrolled into the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPVs) were calculated for the CRP and NLR measured on the 4th postoperative day (POD). Results: Among 724 patients, AL was diagnosed in 33 (4.6%). The accuracy of CRP in the detection of AL using area under curve was 0.83 with the optimal cut-off value of 180 mg/L, sensitivity 75%, specificity 91%, PPV 52% and NPV 87%. Also, NLR on POD4 was higher in the AL group: 9.03 ± 4.13 vs. 4.45 ± 2.25; p = 0.0012; sensitivity 69%, specificity 78%, PPV 49%, NPV 88% at cut-off point of 6.5. Moreover, CRP and NLR on POD4 were significantly higher in patients who died in the postoperative period: 239 ± 24 mg/L vs. 199 ± 41 mg/L; p = 0.034 and 10.71 ± 2.08 vs. 8.65 ± 4.67; p = 0.029, respectively). Conclusions: CRP and NLR on POD4 possess the ability to predict the development of AL and postoperative mortality after CRC operation. Based on our results, high NPV might be indicative of patients with low risk of AL in their postoperative period.

show abstract

Section: Discussionsupporting

confidence: 89%

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Mik¹,

Dziki²,

Berut³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

show abstract

“…Therefore, frailty for the cohort was unknown and may differ from other regional cohorts. Whilst C-reactive protein (CRP) may have a role for predicting those who are unlikely to have abdominal infections following surgery [29], there is no strong evidence to suggest it predicts mortality following laparotomy and it has not been assessed here. There may be some reporting bias introduced to the NELA data recording in the perioperative phases of surgeon and anaesthetist self-reporting.…”

Section: Discussionmentioning

confidence: 99%

Emergency Abdominal Surgery in the Elderly: Can We Predict Mortality?

et al. 2016

View full text Add to dashboard Cite

BackgroundThe United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. Aims: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care.MethodsObservational study of consecutive patients aged 70 and over fulfilling the National Emergency Laparotomy Audit criteria from a tertiary hospital. The predictive value of pre-operative P-POSSUM, ASA, lactate and other routine variables was assessed. Surgical review, decision to operate, consultant surgical review, antibiotic prescription, laparotomy and discharge or death time points were assessed by 30-day survival.ResultsOne hundred and ninety-three patients were included. This represented 46.28 % of those undergoing an emergency laparotomy in our centre. Pre-operative P-POSSUM scoring, ASA grade and lactate were moderate predictors of mortality (AUC 0.784 and 0.771, respectively, lactate AUC 0.705, all p ≤ 0.001). No correlation existed between pre-operative P-POSSUM and days to death (p = 0.209), nor were there delays in key management timings in those who died in 30 days.ConclusionsP-POSSUM scoring may predict inpatient mortality with moderate discrimination. Addition of frailty scoring in this high-risk group might better identify those with a high risk of mortality after emergency laparotomy and would be a fertile area for further research.

show abstract

“…The CRP is synthesized by hepatocytes as a response of inflammation stimulated by interleukin 6 [11]. Increase in CRP levels is observed about 2 days after the initiation of inflammation and due to its short half-life time it is determined as a valuable marker to detect postoperative complications [11]. The PCT is a protein produced by C-cells of the thyroid gland, which increase in patients with severe bacterial infections and sepsis [12].…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy.

Frask¹,

Orłowski²,

Dowgiałło-Wnukiewicz

et al. 2017

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

IntroductionAmong the most common early complications after bariatric surgery are anastomosis leak and bleeding. In order to react quickly and perform accurate treatment before the clinical signs appear, early predictors should be found. In the study C-reactive protein (CRP) and procalcitonin (PCT) levels were investigated. Characterized by a relatively short half-life, they can predict surgical complications.AimTo develop and implement certain standards for early detection of complications.Material and methodsThe study involved 319 adults who underwent laparoscopic sleeve gastrectomy (LSG) as a surgical intervention for morbid obesity at the Department of General Surgery of Ceynowa Hospital in Wejherowo. Every patient had CRP and PCT levels measured before the surgery and on the 1st and 2nd postoperative day (POD).ResultsEarly postoperative complications occurred in 19 (5.96%) patients. Septic and non-septic complications occurred in 3 and 16 patients respectively. Among the patients with septic postoperative complications CRP level increased significantly on the 2nd POD compared to the remainder (p = 0.0221). Among the patients with non-septic postoperative complications CRP level increased significantly on the 1st and 2nd POD compared to the remainder. Among the patients with septic and non-septic postoperative complications PCT level increased significantly on the 2nd POD compared to the remainder.ConclusionsThe CRP and PCT level are supposed to be relevant diagnostic markers to predict non-septic and septic complications after LSG.

show abstract

Meta-analysis of the predictive value of C-reactive protein for infectious complications in abdominal surgery

Abstract: The negative predictive value of serum CRP concentration on day 4 after surgery facilitates reliable exclusion of postoperative infectious complications.

Cited by 109 publications

References 55 publications

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Emergency Abdominal Surgery in the Elderly: Can We Predict Mortality?

Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy.

Contact Info

Product

Resources

About