C-reactive protein kinetics after major surgery

Area of Science:

• Critical Care Medicine
• Surgical Infection Markers
• Inflammatory Response

Background:

• Diagnosing postoperative sepsis presents challenges.
• Interpreting inflammatory markers like C-reactive protein (CRP) is complex in surgical patients.
• This study investigates CRP and white blood cell count changes in postoperative patients with and without infection.

Purpose of the Study:

• To evaluate changes in blood C-reactive protein (CRP) levels and white blood cell counts.
• To differentiate between infected and noninfected postoperative patients.
• To assess the utility of CRP in diagnosing postoperative infections.

Main Methods:

• Prospective inclusion of 151 intensive care patients undergoing major surgery.
• Daily screening for infection and daily recording of CRP levels and white blood cell counts for up to 7 days.
• Characterization of patients as infected (n=20) or noninfected (n=117).

Main Results:

• In noninfected patients, CRP levels peaked around postoperative day 3 and remained elevated.
• Postoperative infection occurred in 13.2% of patients.
• Infected patients showed significantly higher CRP levels on postoperative day 1 compared to noninfected patients.

Conclusions:

• C-reactive protein (CRP) levels increase post-surgery, with a more pronounced rise in infected patients.
• Persistently high CRP levels (>100 mg/L) after postoperative day 4 are indicative of infection.
• CRP monitoring aids in the early detection of postoperative infections.