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

Abstract

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.

Myocardial Perfusion Imaging and C-Reactive Protein in Myocardial Ischemia: A Retrospective Single-Center Study

“…Cumulative evidence indicates that inflammation, both at the focal and systemic levels, plays a role in the disruption of atherosclerotic plaques and acute cardiovascular consequences [7]. Its evaluation in cardiovascular disease appears to be associated with altered CRP and increased cardiovascular risk [8][9][10]. Thus, recent studies tried to elucidate if inflammatory biomarkers such as CRP may identify patients at risk for acute cardiovascular events for early treatment [11].…”