C-Reactive Protein as a Marker of Postoperative Septic Complications

• Authors: Andrzej Witczak , Piotr Jurałowicz , Bogdan Modzelewski , Małgorzata Gawlik
• Languages of publication: EN

Abstracts

EN

The aim of the study was to answer the question whether or not determination of C-reactive protein in patients after serious abdominal surgeries can be prognostic of septic complications.Material and methods. 36 patients who underwent elective surgeries were included in the study. The patients were included either in the group where no postoperative SIRS developed or in the group where postoperative SIRS did occur. In the seven-day period after the surgery, in 26 patients SIRS was found, and in 10 - sepsis was suspected (according to the ACCP/SCCM definitions). In patients who underwent abdominal surgeries blood concentration of C-reactive protein was determined prior to the surgery (measurement '0'), and then on postoperative days 1, 2, 3, 5 and 7.Results. The test for two variables (C-reactive protein on postoperative days five and seven) showed statistically significant difference, and for one variable (C-reactive protein on day three) - difference at the limit of significance. Thus, it was found that in the postoperative SIRS group the level of C-reactive protein is higher than in the non-SIRS group.Conclusions. Serial measurements of C-reactive protein are useful in the first week after surgery, as they can be prognostic of postoperative septic complications. Such complications can be anticipated if CRP on postoperative day 5 is higher than 1/2 of the maximum CRP concentration on day 2 or day 3, or CRP > 150 mg/L as of postoperative day 3. Unfortunately, the severity of the disease cannot be projected based on C-reactive protein level.

Keywords

EN

C-reactive protein; postoperative septic complications

• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 2
• Pages: 93-98

Dates

published

1 - 2 - 2012

online

9 - 4 - 2012

Contributors

author

Andrzej Witczak

• Department of Gastroenterologic, Oncologic and General Surgery, N. Barlicki University Teaching Hospital No. 1 in Łódź

author

Piotr Jurałowicz

• Department of Gastroenterologic, Oncologic and General Surgery, N. Barlicki University Teaching Hospital No. 1 in Łódź

author

Bogdan Modzelewski

• Department of Gastroenterologic, Oncologic and General Surgery, N. Barlicki University Teaching Hospital No. 1 in Łódź

author

Małgorzata Gawlik

• Department of Gastroenterologic, Oncologic and General Surgery, N. Barlicki University Teaching Hospital No. 1 in Łódź

References

• Emmanuel K, Weighardt H, Bartels H et al.: Current and future concepts of abdominal sepsis. World J Surg 2005 Jan; 29(1): 3-9.[PubMed][Crossref]
• Pepys MB: C-reactive protein fifty years on. Lancet 1981 Mar 21; 1(8221): 653-57.
• Bobilewicz D: Rola diagnostyczna białka Creaktywnego, Przegl Med Labor 2004; 1.
• Lindberg M, Hole A, Johnsen H et. al.: Reference intervals for procalcitonin and C-reactive protein after major abdominal surgery. Scand J Clin Lab Invest 2002; 62(3): 189-94.[Crossref]
• Cox ML, Rudd AG, Gallimore R et al.: Real-time measurement of serum C-reactive protein in the management of infection in the elderly. Age Ageing 1986 Sep; 15(5): 257-66.[PubMed][Crossref]
• Oberhofer D, Rumenjak V, Lazić J et al.: Inflammatory indicators in patients after surgery of the large intestine. Acta Med Croatica 2006 Dec; 60(5): 429-33.
• Meisner M, Tschaikowsky K, Hutzler A et al.: Postoperative plasma concentrations of procalcitonin after different types of surgery. Intensive Care Med 1998 Jul; 24(7): 680-84.
• Fassbender K, Pargger H, Müller W et al.: Interleukin-6 and acute-phase protein concentrations in surgical intensive care unit patients: diagnostic signs in nosocomial infection. Crit Care Med 1993 Aug; 21(8): 1175-80.
• Icard P, Fleury JP, Regnard JF et al.: Utility of C-reactive protein measurements for empyema diagnosis after pneumonectomy. Ann Thorac Surg 1994 Apr; 57(4): 933-36.[Crossref][PubMed]
• Kørner H, Nielsen HJ, Soreide JA et al.: Diagnostic accuracy of C-reactive protein for intraabdominal infections after colorectal resections. J Gastrointest Surg 2009 Sep 13(9): 1599-606. Epub 2009 May; 29.[Crossref][WoS]
• Falcoz PE: Usefulness of procalcitonin in the early detection of infection after thoracic surgery. Eur J Cardiothorac Surg 2005 Jun; 27(6): 1074-78[PubMed][Crossref]
• Reith HB, Mittelkötter U, Wagner R et al.: Procalcitonin (PCT) in patients with abdominal sepsis. Intensive Care Med 2000 Mar; 26 Suppl 2: S165-69.
• Mokart D, Merlin M, Sannini A et al.: Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery. Br J Anaesth 2005 Jun; 94(6): 767-73.[Crossref]
• Póvoa P, Almeida E, Moreira P et al.: C-reactive protein as an indicator of sepsis. Intensive Care Med 1998 Oct; 24(10): 1052-56.
• Ugarte H, Silva E, Mercan D et al.: Procalcitonin used as a marker of infection in the intensive care unit. Crit Care Med 1999 Mar; 27(3): 498-504.[PubMed][Crossref]
• Castelli GP, Pognani C, Cita M et al.: Procalcitonin, C-reactive protein, white blood cells and SOFA score in ICU: diagnosis and monitoring of sepsis. Minerva Anestesiol 2006 Jan-Feb; 72(1-2): 69-80.
• Selberg O, Hecker H, Martin M et al.: Discrimination of sepsis and systemic inflammatory response syndrome by determination of circulating plasma concentrations of procalcitonin, protein complement 3a, and interleukin-6. Crit Care Med 2000 Aug; 28(8): 2793-8.
• Meisner M, Tschaikowsky K, Palmaers T et al.: Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care 1999; 3(1): 45-50.[PubMed][Crossref]
• Suprin E, Camus C, Gacoulin A et al.: Procalcitonin: a valuable indicator of infection in a medical ICU? Intensive Care Med 2000 Sep; 26(9): 1232-38.
• Hogarth MB, Gallimore R, Savage P et al.: Acute phase proteins, C-reactive protein and serum amyloid A protein, as prognostic markers in the elderly inpatient. Age Ageing 1997 Mar; 26(2): 153-58.[Crossref]
• Gabay C, Kushner I: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999 Feb 11; 340(6): 448-54
• Matson A, Soni N, Sheldon J: C-reactive protein as a diagnostic test of sepsis in the critically ill. Anaesth Intensive Care 1991 May; 19(2): 182-86.[PubMed]

Identifiers

DOI

10.2478/v10035-012-0015-2