C-reactive protein as a predictor of postoperative infective complications after curative resection in patients with colorectal cancer

Platt, J.J., Ramanathan, M.L., Crosbie, R.A., Anderson, J.H., McKee, R.F., Horgan, P.G. and McMillan, D.C. (2012) C-reactive protein as a predictor of postoperative infective complications after curative resection in patients with colorectal cancer. Annals of Surgical Oncology, 19(13), pp. 4168-4177. (doi:10.1245/s10434-012-2498-9)

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Abstract

Background Infective complications particularly in the form of surgical site infections including anastomotic leak represent a serious morbidity after colorectal cancer surgery. Systemic inflammation markers, including C-reactive protein (CRP) and white cell count, have been reported to provide early detection. However, their relative predictive value is unclear. The aim of the present study was to examine the diagnostic accuracy of serial postoperative WCC, albumin and CRP in detecting infective complications. Methods White cell count, albumin and CRP were measured postoperatively for 7 days in 454 consecutive patients undergoing surgery for colorectal cancer. All postoperative complications were recorded. The diagnostic accuracy of the white cell count, albumin and CRP values were analyzed by receiver operating characteristics curve analysis with surgical site infective complications as outcome measures. Results One hundred four patients (23 %) developed infective complications, and 26 of them developed an anastomotic leak. CRP was most sensitive to the development of an infective complication, surgical site or at a remote site. On postoperative day 3 CRP the area under the receiver operating characteristic curve was 0.80 (p < 0.001) and the optimal cutoff value was 170 mg/L. This threshold was also associated with an increase in the length of hospital stay (p < 0.001), 30 day mortality (p < 0.05) and 12 month mortality (p < 0.10). Conclusions Postoperative CRP measurement on day 3 postoperatively is clinically useful in predicting surgical site infective complications, including an anastomotic leak, in patients undergoing surgery for colorectal cancer.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ramanathan, Miss Michelle and Horgan, Professor Paul and Platt, Mr Jonathan and McKee, Dr Ruth and McMillan, Professor Donald and Anderson, Mr John
Authors: Platt, J.J., Ramanathan, M.L., Crosbie, R.A., Anderson, J.H., McKee, R.F., Horgan, P.G., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Annals of Surgical Oncology
Publisher:Springer
ISSN:1068-9265
ISSN (Online):1534-4681
Published Online:18 July 2012

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