Preoperative C-Reactive Protein Predicts Mid-Term Outcome After Cardiac Surgery

Cappabianca, Giangiuseppe; Paparella, Domenico; Visicchio, Giuseppe; Capone, Giuseppe; Lionetti, Giosuè; Numis, Flora; Ferrara, Pietro; d’Agostino, Chiara; Schinosa, Luigi de Luca Tupputi

doi:10.1016/j.athoracsur.2006.06.039

Cited by 52 publications

(63 citation statements)

References 29 publications

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“…Clearly, we couldn't confirm these results but our results were same as Gaudin et al study that showed Preoperative CRP level cannot causes in-hospital postoperative complication [10]. Regard to mortality and morbidity rate, our study confirmed previous studies [9] [20] [21].…”

Section: Discussioncontrasting

confidence: 35%

“…In other study, preoperative CRP > 3 mg/dl can predict incidence of postoperative complications such as respiratory dysfunctions [15]. Cappabianca et al showed this event with CRP higher than 0.5 mg/dl [9]. In Pool et al study, preoperative symptoms were associated with postoperative hospital stay [16].…”

Section: Discussionmentioning

confidence: 95%

“…These unnecessary tests in patients' candidates for operation [3] [6] [7] couldn't help to new disease diagnosis and result in further costs, ineffective consultation, delay in operation, increased hospital stay time and probably have been exposed patients to risks of interventions. CRP is an acute phase protein and is very rare in plasma healthy subjects but in inflammation reactions increases suddenly [9] and intensity of elevation has direct association with severity of infection or inflammation [10]. So, it has predicted role that it's preoperative elevation as correlation with high morbidity and mortality rate.…”

Section: Discussionmentioning

confidence: 99%

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The Association between Preoperative Plasma C-Reactive Protein (CRP) Level and Postoperative Adult Heart Surgery Outcome

Bilehjani¹,

Fakhari²,

Farzin³

et al. 2016

OJIM

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Introduction: Careful history and physical examinations are the best ways for preoperative evaluation. Currently, we are recommended to rely on doing them rather than unnecessary and costly laboratory tests for confirmation or diagnosis of disease. The aim of study is the survey of CRP level association to decide further evaluation and expert consultation, newly diagnosed problems and possible effect on postoperative mortality and morbidity. Methods and Materials: In a descriptive retrospective study, hospital documentation of 620 patients older than 18 years undergone heart surgery in Tabriz Shahid Madani hospital was evaluated. Addition to plasma CRP level, patient's demographic information, type of surgery, preoperative significant tests, delay time in surgery start time after anesthesiology visit, cause of requested specialty consultation and treatment recommendation, postoperative complications and mortality rate were recorded and analyzed. Patients were classified according to preoperative plasma CRP level to five groups as negative, +1, +2, +3 and not measured (i.e. they considered as normal (0 -5 mg/l), mildly (5 -40 mg/l), moderately (40 -200 mg/L) or severely increased (>200 mg/l) groups). Results: Of 620 patients, 402 were male and 218 were female. There was not statistically significant correlation among demographic variables (gender, age, weight, and height), heart disease diagnosis and the type of surgery in five groups. In 79 individuals, they were done specialty consultations that most common of them were neurology consultation because of impaired renal laboratory tests. Only 2 cases were due to high CRP level. In any of cases, this preoperative consultation didn't result from new disease cases. CRP plasma level hadn't association with preoperative red blood cell sedimentation level. Prevalence of preoperative acute myocardium infarction was higher in * Corresponding author. B. Eissa et al. 94patients with high CRP level. In group +1, delay time was lower than other groups. The most common causes were cardiac causes. There wasn't statistically significant correlation between CRP level and different postoperative complications. There wasn't significant association between ICU stay time and postoperative hospital stay time and plasma high CRP level. Conclusion: Probably, plasma CRP level increases before surgery in acute myocardial infarction and results in high mortality rate. It seems that routine measurement of CRP in candidates for heart operation is beneficial for mortality rate prediction, so its increasing level can't help to diagnosis newly cases and it isn't prudent to consult with specialist.

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Section: Discussioncontrasting

confidence: 35%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Association between Preoperative Plasma C-Reactive Protein (CRP) Level and Postoperative Adult Heart Surgery Outcome

Bilehjani¹,

Fakhari²,

Farzin³

et al. 2016

OJIM

View full text Add to dashboard Cite

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“…In a similar analysis including 5261 CABG patients, our group could not find that pre-operative CRP affected long-term survival (11). On the other hand, Kangasniemi et al and Cappabianci associated increased pre-operative CRP with increased long-term mortality (20,21). Both of these studies, however, included small patient cohorts and a limited number of risk-factors as well as a mixed population of cardiac surgery patients.…”

Section: Discussionmentioning

confidence: 79%

Risks Associated With the Transfusion of Various Blood Products in Aortic Valve Replacement

Bjursten

Al-Rashidi

Dardashti

et al. 2013

The Annals of Thoracic Surgery

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“…Receiver Operating Characteristic Curve: Utilizing POD2 WBC and readmission to predict safe discharge. Patients with the highest WBC value were more likely to be readmitted = 0.05) in the group with elevated CRP levels (15). A recent meta-analysis reported elevated CRP is considerably valuable in the diagnosis and prognosis of postoperative infections (16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of inflammatory markers as predictors of hospital stay and unplanned readmission after colorectal surgery

Krpata¹,

Keller²,

Samia³

et al. 2013

Polish Journal of Surgery

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Hospital length of stay (LOS) and readmissions continue to be expensive and unexpected events following colorectal surgery (CRS) whether patients follow enhanced recovery pathways or traditional care. Predictors of these adverse events could facilitate identification and optimization of CRS patients. the aim of the study was to examine the impact of white blood cell count (WBC) and C-reactive protein (CRP) levels as predictors of delayed recovery or hospital readmission following CRS. material and methods. Patients undergoing laparoscopic or open abdominal colorectal surgery by a single surgeon were managed using standardized enhanced recovery pathways. Those with postoperative day 2 CRP and white blood cell values were evaluated. Outcomes included 30-day hospital readmission rates and postoperative length of hospital stay. results. CRP values were available for 193 patients (86 Male, mean age 58.6 years). Ninety-nine patients had surgery for colon cancer, 23 for Crohn's disease, 19 for ulcerative colitis, 31 for diverticulitis and 18 for other reasons. Twenty patients (10.4%) were readmitted to the hospital within 30 days of surgery. POD2 CRP accurately predicted short length of hospital stay (p< 0.01). Average CRP was 6.3 in the LOS of < 3 days or less, and 11.7 in patients with LOS >4 days. The mean CRP of the readmission and non-readmission groups was 11.8 and 9.9, respectively (p=0.29). The average POD 2 WBC of the readmission and non-readmission groups was 10.6 and 9 respectively (p=0.01). conclusion. A low POD2 CRP level was correlated with a shorter LOS, but it did not predict readmission. Conversely, POD2 WBC, and the difference in WBC from baseline were associated with readmission. These markers may be useful indicators to predict suitability of early discharge in an ERP. Further evaluation in prospective trials is warranted.

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Preoperative C-Reactive Protein Predicts Mid-Term Outcome After Cardiac Surgery

Cited by 52 publications

References 29 publications

The Association between Preoperative Plasma C-Reactive Protein (CRP) Level and Postoperative Adult Heart Surgery Outcome

The Association between Preoperative Plasma C-Reactive Protein (CRP) Level and Postoperative Adult Heart Surgery Outcome

Risks Associated With the Transfusion of Various Blood Products in Aortic Valve Replacement

Evaluation of inflammatory markers as predictors of hospital stay and unplanned readmission after colorectal surgery

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