C-Reactive protein as a predictor of post-operative complications in bariatric surgery patients

2018 ◽  
Vol 33 (8) ◽  
pp. 2479-2484 ◽  
Author(s):  
Marie Ashley Villard ◽  
Melissa C. Helm ◽  
Tammy L. Kindel ◽  
Matthew I. Goldblatt ◽  
Jon C. Gould ◽  
...  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  

Abstract Background Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2–4) for the detection of post-operative complications. Patients and methods We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011–2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups. Results CRP on post-operative days 2–4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p < 0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p < 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively. Conclusion CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2–4).


2020 ◽  
Vol 3 (1) ◽  
pp. 64-70
Author(s):  
Joshua CC ◽  
Sreejith V ◽  
A. Sreekumar

Background: Major hepato-biliary surgeries carry a high risk for post-operative sepsis. Recent therapeutic advances both medical and surgical have improved early post-operative outcome. Considering the difficulties in diagnosis of infection in critically ill patients an early sensitive  and specific marker for sepsis would be of interest. Studies have shown that C - reactive protein (CRP) and pro calcitonin (PCT) are acute phase reactants and good independent early markers of post-operative sepsis, severe or septic shock. This aspect has not been evaluated in     the hepatobiliary surgeries. More over there is no data available from the Indian sub-continent in this aspect. This study aims to evaluate the efficacy of serum CRP and PCT levels after hepatobiliary surgery for diagnosis of postoperative complication. Subjects and Methods: This is a cross-sectional diagnostic study has conducted in 42 patients who all are satisfying the inclusion criteria. Study duration was From August 2017 to July 2019, conducted on patients between 18-80yrs of age undergoing hepato-biliary surgery, in surgical wards of PK Das Institute     of Medical Sciences. Study variables include age, sex, pre-operative serum albumin level, pre and post-operative S.CRP AND S.PCT levels. On post-operative day 4 and day 7 S.CRP and S.PCT are monitored and its predictability also measured. . Descriptive statistical analysis will be carried out using SPSS (IBM). The p-value of less than 0.05 will be taken as significant. Results: out of 42 patients studied, 30 patients developed post-operative complications. Pre-operative serum C - reactive protein and serum procalcitonin measured compared with pre-operative serum albumin was significant identifying post-operative complications (P-value 0.02). On post-operative day 4 and 7value was significant in post-operative patients with P-value of 0.04 vs. 0.046 respectively. Similarly serum procalcitonin values also were significant on postoperative day (POD) 4 and 7 with P-value of 0.02 and 0.03. Sensitivity and specificity of S.PCT was more compared to S.CRP (92 vs 90% in sensitivity and 100% vs 80% in specificity respectively. This study shows those who were clinically septic post operatively have statistically elevated levels of serum CRP and Procalcitonin. Conclusion: S.PCT is more sensitive and specific as a marker of post operative infection following hepato biliary surgery. Early identification of patients with insidious septic illness allows early therapeutic intervention which may favorably influence outcome.


2020 ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  

Abstract Background Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications. Patients and methods We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups. Results CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively. Conclusion CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).


2020 ◽  
Author(s):  
Antoine El Asmar ◽  
Melissa Bendavides ◽  
Michel Moreau ◽  
Alain Hendlisz ◽  
Amélie Deleporte ◽  
...  

Abstract Background: Relatively high morbidity rates are reported after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). However, early predictors of complications after CRS plus HIPEC have not been identified. The aim of this study was to evaluate the predictive role of early postoperative serum C-reactive protein (CRP) level (Day 2-4) for the detection of post-operative complications.Patients and methods: We performed a retrospective study including 94 patients treated with complete CRS (R1) and HIPEC for PC from various primary origins (2011-2016). Post-operative complications were recorded. The values for postoperative inflammatory markers (white blood cells [WBC] and platelet counts, CRP) were compared between the different groups.Results: CRP on post-operative days 2-4 was significantly higher in patients with than without complications (124 mg/L vs 46 mg/L; p<0.0001) and higher in those with more major complications (162 mg/L vs 80 mg/L; p< 0.0012). WBC and platelet counts showed no difference within 5 days postoperatively.Conclusion: CRP levels, and kinetics mainly, between post-operative day 2 and 4, are decisive predictive markers of early and late post-operative complications after CRS plus HIPEC. The presence of post-operative complications should be suspected in patients with a high CRP mean, and a plateau level (days 2-4).


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 721
Author(s):  
Tannaz Jamialahmadi ◽  
Mohsen Nematy ◽  
Simona Bo ◽  
Valentina Ponzo ◽  
Ali Jangjoo ◽  
...  

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.


2019 ◽  
Vol 29 (9) ◽  
pp. 2964-2971 ◽  
Author(s):  
K. Hope Wilkinson ◽  
Melissa Helm ◽  
Kathleen Lak ◽  
Rana M. Higgins ◽  
Jon C. Gould ◽  
...  

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