Impact of day 2 C-reactive protein on day 3 and 4 thresholds associated with infective complications following curative surgery for colorectal cancer

Ramanathan, M.L., MacKay, G., Platt, J., Horgan, P.G. and McMillan, D.C. (2013) Impact of day 2 C-reactive protein on day 3 and 4 thresholds associated with infective complications following curative surgery for colorectal cancer. World Journal of Surgery, 37(11), pp. 2705-2710. (doi:10.1007/s00268-013-2177-4)

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Abstract

Background The postoperative systemic inflammatory response, as evidenced by C-reactive protein (CRP) on days 3 and 4, has been reported to be associated with the development of infective complications following surgery for colorectal cancer. However, patients in enhanced recovery after surgery require earlier assessment at day 2, the peak CRP response to surgery. The aim of the present study was to assess the impact of day 2 CRP on the CRP concentrations on days 3 and 4.<p></p> Methods Patients with colorectal cancer undergoing elective resection were recorded in a prospective database (n = 357). CRP was measured preoperatively and on days 1–4 postoperatively. Correlations between day 2 CRP and day 3 and day 4 CRP concentrations were examined.<p></p> Results The majority of patients were ≥65 (72 %), male (53 %), underwent right or left hemicolectomy (63 %), and had node-negative disease (61 %). Day 2 CRP was not significantly associated with age, sex, operation type, or tumor stage. Day 2 CRP was directly associated with day 3 (r 2 = 0.601, p < 0.001) and day 4 (r 2 = 0.270, p < 0.001) CRP. The median day 2 CRP that corresponded with the previously described thresholds for predicting infective complications was ~190 mg/L, and for predicting an anastomotic leak 200 mg/L.<p></p> Conclusions A day 2 CRP concentration >190 mg/L was associated with day 3 and 4 CRP concentrations above established CRP thresholds for the development of infective complications.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ramanathan, Miss Michelle and Horgan, Professor Paul and McMillan, Professor Donald
Authors: Ramanathan, M.L., MacKay, G., Platt, J., Horgan, P.G., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:World Journal of Surgery
Publisher:Springer
ISSN:0364-2313
ISSN (Online):1432-2323

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