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

van Winsen, M., McSorley, S. T. , McLeod, R., MacDonald, A., Forshaw, M. J., Shaw, M. and Puxty, K. (2021) Postoperative C-reactive protein concentrations to predict infective complications following gastrectomy for cancer. Journal of Surgical Oncology, 124(7), pp. 1060-1069. (doi: 10.1002/jso.26613) (PMID:34350587)

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McSorley, Dr Stephen and Puxty, Dr Kathryn and Shaw, Dr Martin and Forshaw, Mr Matthew and MacDonald, Dr Andrew and Van Winsen, Dr Marjolein
• Authors: van Winsen, M., McSorley, S. T., McLeod, R., MacDonald, A., Forshaw, M. J., Shaw, M., and Puxty, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Surgical Oncology
• Publisher: Wiley
• ISSN: 0022-4790
• ISSN (Online): 1096-9098
• Published Online: 05 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Journal of Surgical Oncology 124(7): 1060-1069
• Publisher Policy: Reproduced under a Creative Commons License