Diagnostic accuracy of C-reactive protein and white blood cell counts in the early detection of inflammatory complications after open resection of colorectal cancer: a retrospective study of 1,187 patients

Warschkow, René; Tarantino, Ignazio; Torzewski, Michael; Näf, Franziska; Lange, Jochen; Steffen, Thomas

doi:10.1007/s00384-011-1262-0

Cited by 82 publications

(67 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These authors found that CRP level above 143 mg/L had a good diagnostic accuracy to detect infectious complications with an AUC ROC 0.76 [46]. We found similar results and CRP time course showed to be useful in the early detection of an infectious complication after elective colorectal surgery.…”

Section: Discussionsupporting

confidence: 83%

“…Similar to previous published studies, measurements of WCC contribute little to the early detection of infectious surgical complications [46]. …”

Section: Discussionsupporting

confidence: 81%

“…More recently Warschkow et al [46] demonstrated that CRP values exceeding 123 mg/l on POD 4 where associated a higher risk of infectious complications. These authors found that CRP level above 143 mg/L had a good diagnostic accuracy to detect infectious complications with an AUC ROC 0.76 [46].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery – a pilot study

et al. 2014

View full text Add to dashboard Cite

BackgroundColorectal surgery is associated with postoperative infectious complications in up to 40% of cases, but the diagnosis of these complications is frequently misleading, delaying its resolution. Several biomarkers have been shown to be useful in infection diagnosis.MethodsWe conducted a single-centre, prospective, observational study segregating patients submitted to elective colorectal surgery with primary anastomosis, CRP and PCT were measured daily. We compared infected and non-infected patients.ResultsFrom October 2009 to June 2011, a total of 50 patients were included. Twenty-one patients developed infection. PCT and CRP before surgery were equally low in patients with or without postoperative infectious complications. After surgery, both PCT and CRP increased markedly. CRP time-course from the day of surgery onwards was significantly different in infected and non-infected patients (P = 0.001) whereas, PCT time-course was almost parallel in both groups (P = 0.866). Multiple comparisons between infected and non-infected patients from 5th to 9th postoperative days (POD) were performed and CRP concentration was significantly different (P < 0.01, Bonferroni correction), on the 6th, 7th and 8th POD. A CRP concentration > 5.0 mg/dl at the D6 was predictive of infection with a sensitivity of 85% and a specificity of 62% (positive likelihood ratio 2.2, negative likelihood ratio 0.2).ConclusionsAfter a major elective surgical insult both CRP and PCT serum levels increased independently of the presence of infection. Besides serum CRP time-course showed to be useful in the early detection of an infectious complication whereas PCT was unhelpful.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-444) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 83%

“…Similar to previous published studies, measurements of WCC contribute little to the early detection of infectious surgical complications [46]. …”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery – a pilot study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Intra-abdominal infection caused by an anastomotic leak after colorectal surgery was correlated with prolonged CRP concentrations over 125–190 mg/L or higher on the third postoperative day [10]. Similarly, this persistent CRP elevation and levels higher than 140 mg/L on postoperative [9], [13], [14], [15] days 3 and 4 were predictive for infectious postoperative complications (86% and 91%) [9]. Despite of our large group of patients, we could not confirm this finding.…”

Section: Discussionmentioning

confidence: 75%

The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

et al. 2013

View full text Add to dashboard Cite

IntroductionC-reactive Protein (CRP) is used next to clinical scoring systems to recognize critically ill patients prone to develop complications on the Intensive Care Unit (ICU). The purpose of this study is to assess the predictive value of CRP as parameter for clinical deterioration and/or clinical decision making as ordering diagnostic procedures or performing (re)interventions. Also, we wanted to determine the value of CRP in early detection of surgical complications in the critically ill general surgical patient in the ICU and its interpretation in adjunct to a clinical scoring system, the Sequential Organ Failure Assessment Score.Materials and MethodsIn our prospective observational study, 174 general surgical patients admitted into the Intensive Care Unit were included. We evaluated the Sequential Organ Failure Assessment Score (SOFA) and daily measured the C-reactive protein (CRP) concentrations. All events (diagnostic or therapeutic interventions) and surgical complications were registered. Then the relationship between SOFA score, CRP concentrations, events and complications were studied.ResultsEach 10% increase in CRP resulted in a 3.5% increase in the odds of an event (odds ratio 1.035, 95% CI: 1.004–1.068; p = 0.028). However, an increase in CRP levels did not lead to a higher odds of complication (OR 0.983, 95% CI: 0.932–1.036; p = 0.52). When adjusting for the SOFA score the effect of CRP on the probability of a first event remained significant (OR 1.033, 95% CI: 1.001–1.065; p = 0.046), and again did not significantly affect the complication probability (OR 0.980, 95% CI: 0.929–1.035; p = 0.46).ConclusionsAn increase in C-reactive protein is a poor parameter for early detection of complications in the critically ill surgical patient in the ICU by means of diagnostic procedures or therapeutic (re)-interventions.

show abstract

“…Several studies demonstrated that a prognostic significant level of CRP is 180 mg/L and higher. This provides grounds for a high prognostic significance of CRP in patients with anastomosis [16]. At the same time, the results of some meta-analyses showed that the concentration of CRP on the 3 rd -5 th day after the surgery is a useful negative prognostic test and not a good positive predictor [1; 17].…”

Section: Introductionmentioning

confidence: 99%

Features of Laboratory Monitoring for Early Detection of Colonic Anastomosis Leak

Shpak¹,

Pozdnyakov²,

Черданцев³

et al. 2018

MPSES

View full text Add to dashboard Cite

Aims.The work was aimed at identifying the characteristics of the dynamics of changes in laboratory parameters in patients with colonic anastomosis leak for early diagnosis of postoperative complications. Materials and methods.The dynamics of laboratory parameters of blood and peritoneal effusion on the first to seventh postoperative day was studied in 102 patients operated on for colorectal cancer. All patients had complete resection of the colon with tumour; surgery was ended with interintestinal anastomosis. A single-layer continuous blanket anastomosis and machine stapling anastomosis were used. The following laboratory parameters were investigated: C-reactive protein, pyruvate and lactate concentration, pH of peritoneal effusion and leukocytic index of intoxication. Results.The development of leaking intestinal anastomosis was detected in 8.8%. The most clinically significant indicators for early diagnosis of anastomosis leak were leukocytic index of intoxication, C-reactive protein, pH of effusion in the abdominal cavity and the ratio of the effusion lactate to blood plasma lactate. Conclusions.The combined use of these parameters allows suspecting with a high degree of reliability of the leak of intestinal anastomosis as early as on the third day after surgery.

show abstract

Diagnostic accuracy of C-reactive protein and white blood cell counts in the early detection of inflammatory complications after open resection of colorectal cancer: a retrospective study of 1,187 patients

Cited by 82 publications

References 30 publications

Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery – a pilot study

Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery – a pilot study

The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

Features of Laboratory Monitoring for Early Detection of Colonic Anastomosis Leak

Contact Info

Product

Resources

About