C-reactive protein in the diagnosis of postoperative infection in pediatric patients: a prospective observational study of 103 patients

Báez, Yolanda Laporta; Rodríguez, Miguel Ángel Palomero; Sánchez, Jesus Carlos De Vicente; Carretero, P. Sanabria; Martı́nez, Daniel; Ferrer, Antonio Pérez; Villoria, Clemente Muriel; Rodríguez, Fernando

doi:10.1016/j.jpedsurg.2011.03.014

Cited by 14 publications

(6 citation statements)

References 28 publications

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“…Early in the 1930s, C-reactive protein (CRP) was discovered as a type of protein that can react with the pneumococcal capsular component C polysaccharide. The serum CRP concentration is relatively low in the normal human body, however, in inflammation, burns, surgery, trauma and other stress states, the CRP concentration can be increased within 6 h after tissue trauma, reaching a peak in one to three days ( 15 , 16 ), which is 2,000 times higher than the normal physiological value. As a specific stress marker, CRP is one of the most sensitive acute phase proteins produced by the stress response.…”

Section: Discussionmentioning

confidence: 94%

Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Gong

et al. 2017

Exp Ther Med

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We compared the clinical effects of minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO) and open surgery on the repair of thoracolumbar vertebra fracture. Seventy patients, who suffered from thoracolumbar vertebra fracture and received treatment at our hospital, were selected and randomly divided into either the minimally invasive percutaneous pedicle screws osteosynthesis group (MIPPSO group) and the traditional open pedicle screws osteosynthesis group (TOPSO group) with 35 cases in each group. The perioperative parameters including length of incision, duration of operation, bleeding during operation, length of hospital stay, the changes of pre-operative and post-operative VAS pain scores, inflammatory indexes including serum C-reactive protein (CRP) and creatine kinase (CK), and imaging indexes including Cobb's angle and anterior margin height of vertebral body of both groups were compared. The length of incision, duration of operation, bleeding volume during operation and length of hospital stay in the MIPPSO group were significantly lower than those in the TOPSO group (P<0.05). Both minimally invasive surgery and traditional surgery effectively alleviated the pain (P<0.05), which was more significant in MIPPSO group (P<0.05). The post-operative inflammatory indexes, CRP and CK levels, of both groups were higher compared to the pre-operation (P<0.05), which was more significant in TOPSO group (P<0.05). The differences of imaging indexes, including Cobb's angle and anterior margin height of injured vertebra, were statistically significant between pre-operation and post-operation for each group (P<0.05); however, there were no statistically significant differences between two groups at either pre-operation or post-operation (P>0.05). The effect of minimally invasive percutaneous pedicle screws osteosynthesis is similar to the traditional open surgery, however, the MIPPSO technique has the advantages of small trauma, less bleeding, short duration of operation, rapid post-operative recovery, light pain, less economic cost, and better aesthetic effect and is therefore worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 94%

Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Gong

et al. 2017

Exp Ther Med

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“…CRP is an acute-phase reactant and a sensitive systemic marker of inflammation and tissue injury [26]. However, under stressful conditions such as inflammation, burns, surgery, and trauma, the CRP level increases rapidly within six to eight hours after tissue injury and reaches a peak in 48 ~ 72 hours [27,28]. The change in serum CRP concentration is positively correlated with the degree of surgical trauma, which is a Fig.…”

Section: Discussionmentioning

confidence: 99%

Comparative prospective randomized study of minimally invasive transpiriformis approach versus conventional posterolateral approach in total hip arthroplasty as measured by biology markers

Xiao

Gao

Zhang

et al. 2021

International Orthopaedics (SICOT)

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Background Minimally invasive surgery is becoming increasingly common, but evidence of the advantages of the minimally invasive transpiriformis approach in total hip arthroplasty is limited. Therefore, our single-centre randomized controlled trial evaluated the benefits of this approach versus the posterolateral approach. Methods Forty-nine patients undergoing the minimally invasive transpiriformis approach and 57 patients undergoing the posterolateral approach total hip arthroplasty were analyzed. The operative time, length of hospital stay, incision length, and peri-operative data related to the surgery were recorded. In both groups, serum CRP, IL-6, HGb, Hct, MB, CK-MB, and CK levels, Harris hip scores, and VAS scores were recorded. Results Patients who underwent the minimally invasive transpiriformis approach had a smaller surgical incision (9.10 ± 0.94 vs. 15.56 ± 1.20 cm, P = 0.00) and shorter hospital stay (6.20 ± 1.54 vs. 12.26 ± 2.97 days, P = 0.00) than those who underwent the posterolateral approach. Serum levels of CRP, IL-6, MB, CK-MB, and CK were also lower. According to the Harris hip score, the minimally invasive transpiriformis group showed significant improvement at one week and one month after surgery. Conclusion Compared to the posterolateral approach, the minimally invasive transpiriformis approach for total hip arthroplasty provided rapid functional recovery, elicited a significantly reduced post-operative inflammatory response, and caused less muscle damage.

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“…We report an increased CRP level in those with post-operative infections on all of the first five post-operative days. Baez et al described the post-operative kinetics of CRP in 103 paediatric patients undergoing a broad range of pan-speciality surgical procedures and found a rise of 110mg/L in 48 hours to be predictive of infection [15].…”

Section: Discussionmentioning

confidence: 99%

“…The post-operative kinetics of CRP have been described in the paediatric population in a relatively small cohort across a broad range of pan-specialty procedures [15] and in a small number of children undergoing a range of orthopaedic procedures [16]. We could find no description in the literature of the trends of CRP following bony hip surgery in children with severe CP.…”

Section: Introductionmentioning

confidence: 91%

C-reactive protein: what to expect after bony hip surgery for nonambulatory children and adolescents with cerebral palsy

Dick

Magill²,

White

et al. 2019

Journal of Pediatric Orthopaedics B

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Bony hip reconstruction surgery in children with severe cerebral palsy (CP) is associated with high complication rates, usually post-operative chest and urinary tract infections. C-reactive protein (CRP) level is commonly used as an indication of infection; an understanding of its normal post-operative trends is crucial to allow early identification of abnormal levels and possible infection. Our aim was to describe the trends in CRP following bony hip surgery in children who had an uneventful post-operative course, on the basis that the children for whom CRP does not follow this course are likely to have a bacterial infection. Methods A retrospective review was performed of 155 children with CP having bony hip surgery between 2012 and 2016. The median age was 9.9 years (interquartile range 6.6-12.7). One hundred (64.5%) patients had a Gross Motor Function Classification System rating of V. All CRP levels measured in routine post-operative care were recorded, and medical records were examined for post-operative infective complications. The CRP levels of patients with clinically proven infections were excluded in order to describe what to expect in the absence of infection. Results Mean CRP peaked on the third post-operative day at 81mg/L in those who had no post-operative infection. Twenty-five patients (16.1%) had a post-operative infection; their mean CRP was higher on all post-operative days and peaked at 128 mg/L on the third post-operative day. Conclusions An understanding of the normal post-operative trends in CRP allows identification of those with abnormally raised levels. Post-operative CRP is consistently higher in children with an infective complication. We recommend that the CRP should be routinely checked following bony hip surgery in children with CP, and a careful search for infection undertaken in those with a raised level.

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C-reactive protein in the diagnosis of postoperative infection in pediatric patients: a prospective observational study of 103 patients

Cited by 14 publications

References 28 publications

Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Comparative prospective randomized study of minimally invasive transpiriformis approach versus conventional posterolateral approach in total hip arthroplasty as measured by biology markers

C-reactive protein: what to expect after bony hip surgery for nonambulatory children and adolescents with cerebral palsy

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