Postoperative C‐reactive protein concentrations to predict infective complications following gastrectomy for cancer

Abstract

Background and Objectives: Gastrectomy for gastric cancer is associated with significant infective postoperative complications. C-reactive protein (CRP) is a useful biomarker in the early detection of infective complications following major abdominal surgery. This single-centre retrospective study aimed to determine the relationship between postoperative CRP levels and development of postoperative infective complications after gastrectomy.Methods: Daily postoperative CRP levels were analyzed to determine a CRP threshold associated with infective complications. ROC curve analysis was used to determine which postoperative day (POD) gave the optimal cutoff. Multivariate analysis was performed to determine significant factors associated with complications.Results: One hundred and forty-four patients were included. A total of 61 patients (42%) had at least one infective complication. A CRP level of 220 mg/L was associated with the highest AUC (0.765) with a sensitivity of 70% and specificity of 76% (positive predictive value, 67%; negative predictive value, 78%). More patients with a CRP > 220 mg/L on POD 3 developed infective complications (67% vs. 21%, p < 0.001).Conclusions: A CRP of more than 220 mg/L on POD 3 may be useful to alert clinicians to the increased risk of a postoperative infective complication or enable earlier safe discharge from critical care for those with a lower value.

Neutrophil-lymphocyte ratio as a predictive marker for postoperative infectious complications: A systematic review and meta-analysis

“…A meta-analysis of CRP [ 4 ] involving 7 cohort studies demonstrated a lower AUC (0.76) for predicting postsurgical infection complications when compared to NLR (0.84) in our meta-analysis. The AUC in the most recent study of CRP by Winsen M and colleagues was only 0.765 [ 30 ]. As for procalcitonin, the levels were insignificantly different between the infection and non-infection groups in spinal instrumentation surgery [ 7 ].…”

Postoperative C‐reactive protein concentrations to predict infective complications of gastric cancer

“…We have read with interest the article published by van Winsen et al 1 Although we believe it is a very interesting topic, we would like to offer the following points for your consideration.…”

A cost-effective smartphone-based device for rapid C-reaction protein (CRP) detection using magnetoelastic immunosensor

“…3 In addition, diseases like postoperative infection, cardiovascular disease, and cancer can cause elevated levels of CRP. 4,5 CRP was also used as a non-specific marker to diagnose notable COVID-19 for a time. 6 Therefore, methods of CRP sensing have aroused widespread interest in clinical trials.…”