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Published on: September 21, 2015
C-reactive protein as early predictor for infectious postoperative complications in rectal surgery
T Welsch1, S A Müller, A Ulrich
1Department of General Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
International Journal of Colorectal Disease
|July 20, 2007
Summary
Persistent C-reactive protein (CRP) elevation after postoperative day 2 predicts complications following rectal resection. A CRP level above 140 mg/dl on postoperative days 3-4 strongly indicates infectious complications, aiding early diagnosis.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Clinical Chemistry
Background:
- Assessing C-reactive protein (CRP) role in early identification of postoperative complications after rectal resections.
- Utilizing a prospective database of 383 rectal resections with primary anastomosis for rectal cancer.
Purpose of the Study:
- To evaluate the predictive value of CRP for infectious postoperative complications.
- To establish CRP cutoff levels for early complication detection.
Main Methods:
- Prospective screening of 383 rectal resections for infectious complications.
- Matching 48 complicated cases with 48 uncomplicated cases.
- Analyzing CRP, white blood cells, and body temperature trends on postoperative days (PODs).
Main Results:
- In uncomplicated cases, CRP peaked on POD 2 and declined; in complicated cases, CRP remained elevated.
- A CRP cutoff of 140 mg/dl on PODs 3 and 4 showed high predictive values (85.7-90.5%) for complications.
- CRP elevation on PODs 3-4 was significant (P<0.001) even when other inflammatory markers were normal.
Conclusions:
- Persistent CRP elevation post-POD 2 predicts infectious complications.
- Serum CRP > 140 mg/dl on PODs 3-4 warrants investigation for inflammatory processes, particularly anastomotic leaks.
- CRP is a valuable early marker for identifying postoperative complications after rectal surgery.