The role of C-reactive protein after surgery for obesity and metabolic disorders

Chiappetta, Sonja; Jamadar, Parvezikbal; Stier, Christine; Bottino, Vincenzo; Weiner, Rudolf A.; Runkel, N.

doi:10.1016/j.soard.2019.10.007

Cited by 19 publications

(8 citation statements)

References 34 publications

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“…Due to the actual pandemic and the discussion regarding IL-6, we reanalyzed a subpopulation of patients (Sana Klinikum Offenbach, Germany), who participated in our recent inflammation study [20,21] and underwent measurement of IL-6 (pg/ml) in the standard preoperative work up (n = 33). The study aimed to compare different bariatric procedures pertaining with their effects on inflammation markers in the short and long term and was conducted in accordance with the principles of the Declaration of Helsinki.…”

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confidence: 99%

“…In conclusion, further studies are necessary to confirm the role of chronic inflammation and IL-6 due to obesity in the pathogenesis of COVID-19 and SARS-CoV-2. Physicians should be aware of the risk of hyperinflammation in Table 1 Baseline demographic data of a subpopulation of patients (n = 33), who participated in the inflammation study [20,21] and underwent measurement of IL-6 (pg/ml) in the standard preoperative work up. Standard values of C-reactive protein (CRP) and interleukin-6 (IL-6) are <5 mg/l and <7 pg/ml.…”

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confidence: 99%

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COVID-19 and the role of chronic inflammation in patients with obesity

Chiappetta¹,

Sharma

Bottino³

et al. 2020

Int J Obes

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213

166

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Coronavirus disease 2019 (COVID-19) and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a particular risk to people living with preexisting conditions that impair immune response or amplify pro-inflammatory response. Low-grade chronic systemic inflammation, common in people with obesity, is associated with the development of atherosclerosis, type 2 diabetes, and hypertension, well known comorbidities that adversely affect the outcomes of patients with COVID-19. Risk stratification based on the Edmonton Obesity Staging System (EOSS), which classifies obesity based on the presence of medical, mental, and/or functional complications rather than on body mass index (BMI), has been shown to be a better predictor of all-cause mortality and it may well be that EOSS stages may better describe the risk of hyperinflammation in patients with COVID-19 infection. Analyzing a group of metabolic ill patients with obesity (EOSS 2 and 3), we found an increased interleukin-6 and linear regression analysis showed a positive correlation with C-reactive protein (CRP) (p = 0.014) and waist-to-hip-ratio (WHR) (p = 0.031). Physicians should be aware of these findings in patients with COVID-19 infection. Early identification of possible hyperinflammation could be fundamental and should guide decision making regarding hospitalization, early respiratory support, and therapy with immunosuppression to improve mortality.

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confidence: 99%

mentioning

confidence: 99%

COVID-19 and the role of chronic inflammation in patients with obesity

Chiappetta¹,

Sharma

Bottino³

et al. 2020

Int J Obes

Self Cite

213

166

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“…Discharge on postoperative day 1 or 2 was not associated with an increase in the complication rate, readmission, or telephone consultations in both ERAS [ 3 , 18 ] and ERABS [ 11 , 12 , 175 ], particularly in the absence of significant comorbidities [ 176 , 177 ]. Caution should be taken in the presence of suspected clinical conditions (e.g., tachycardia) and/or abnormal level of serological markers (e.g., C-reactive protein, procalcitonin) as predictors of risk of postoperative complications [ 178 – 181 ]. However, there is no consensus on which serological markers should be assessed and at which postoperative time point [ 182 – 185 ].…”

Section: Resultsmentioning

confidence: 99%

Enhanced recovery after bariatric surgery: an Italian consensus statement

Marinari

Foletto²,

Nagliati

et al. 2022

Surg Endosc

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Background Enhanced recovery after bariatric surgery (ERABS) is an approach developed to improve outcomes in obese surgical patients. Unfortunately, it is not evenly implemented in Italy. The Italian Society for the Surgery of Obesity and Metabolic Diseases and the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care joined in drafting an official statement on ERABS. Methods To assess the effectiveness and safety of ERABS and to develop evidence-based recommendations with regard to pre-, intra-, and post-operative care for obese patients undergoing ERABS, a 13-member expert task force of surgeons and anesthesiologists from Italian certified IFSO center of excellence in bariatric surgery was established and a review of English-language papers conducted. Oxford 2011 Levels of Evidence and U.S. Preventive Services Task Force Grade Definitions were used to grade the level of evidence and the strength of recommendations, respectively. The supporting evidence and recommendations were reviewed and discussed by the entire group at meetings to achieve a final consensus. Results Compared to the conventional approach, ERABS reduces the length of hospital stay and does not heighten the risk of major post-operative complications, re-operations, and hospital re-admissions, nor does it increase the overall surgical costs. A total of 25 recommendations were proposed, covering pre-operative evaluation and care (7 items), intra-operative management (1 item, 11 sub-items), and post-operative care and discharge (6 items). Conclusions ERABS is an effective and safe approach. The recommendations allow the proper management of obese patients undergoing ERABS for a better outcome.

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“…The presence of inflammation and nutritional impairment are well-known risk factors for poor prognosis. The presence of infection, comorbidities, and malnutrition are shown to induce inflammation and deterioration of a patient's nutritional status [15][16][17], and this is likely to also be found in patients anticipating a scheduled surgery. In surgical patients, pre-existing inflammation can worsen malnutrition and increase the inflammatory response to surgical injuries [18], which can have a significant impact on mortality.…”

Section: Discussionmentioning

confidence: 99%

Association between Preoperative C-Reactive Protein-to-Albumin Ratio and Mortality after Plastic and Reconstructive Surgery

Oh,

Sung,

Park

et al. 2024

JCM

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Background: Prognostic markers have not been extensively studied in plastic and reconstructive surgery. Objective: We aimed to evaluate the prognostic value of preoperative C-reactive protein (CRP)-to-albumin ratio (CAR) in plastic and reconstructive surgery and to compare it with the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS). Methods: From January 2011 to July 2019, we identified 2519 consecutive adult patients who were undergoing plastic and reconstructive surgery with available preoperative CRP and albumin levels. The receiver operating characteristic (ROC) curve was generated to evaluate predictability and estimate the threshold. The patients were divided according to this threshold, and the risk was compared. The primary outcome was one-year mortality, and the overall mortality was also analyzed. Results: The one-year mortality was 4.9%. The CAR showed an area under the ROC curve of 0.803, which was higher than those of NLR, PLR, and mGPS. According to the estimated threshold of 1.05, the patients were divided into two groups; 1585 (62.9%) were placed in the low group, and 934 (37.1%) were placed in the high group. After inverse probability weighting, the mortality rate during the first year after plastic and reconstructive surgery was significantly increased in the high group (1.3% vs. 10.9%; hazard ratio, 2.88; 95% confidence interval, 2.17–3.83; p < 0.001). Conclusions: In this study, high CAR was significantly associated with one-year mortality of patients after plastic and reconstructive surgery. Further studies are needed on prognostic markers in plastic and reconstructive surgery.

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The role of C-reactive protein after surgery for obesity and metabolic disorders

Cited by 19 publications

References 34 publications

COVID-19 and the role of chronic inflammation in patients with obesity

COVID-19 and the role of chronic inflammation in patients with obesity

Enhanced recovery after bariatric surgery: an Italian consensus statement

Association between Preoperative C-Reactive Protein-to-Albumin Ratio and Mortality after Plastic and Reconstructive Surgery

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