scholarly journals C-reactive protein for predicting infectious complications after colorectal surgery within enhanced recovery after surgery: Results from Thailand's largest university hospital

2020 ◽  
Vol 43 (10) ◽  
pp. 1012-1013
Author(s):  
Varut Lohsiriwat ◽  
Bundhawich Polakla ◽  
Sarinda Lertbannaphong
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Infectious Complications ◽  
University Hospital ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Clinical predictive efficacy of C-reactive protein for diagnosing infectious complications after gastric surgery

2020 ◽  
Vol 13 ◽  
pp. 175628482093654
Author(s):  
Jinyao Shi ◽  
Zhouqiao Wu ◽  
Qi Wang ◽  
Yan Zhang ◽  
Fei Shan ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Anastomotic Leakage ◽  
Enhanced Recovery ◽  
Gastric Surgery ◽  
Infectious Complications ◽  
C Reactive Protein ◽  
Characteristic Analysis ◽  
Training Set ◽  
Reactive Protein ◽  
Validation Set

Background: With the popularization of Enhanced Recovery After Surgery (ERAS), identifying patients with complications before discharging becomes important. This study aimed to explore the efficacy of C-reactive protein (CRP) in predicting infectious complications after gastrectomy. Methods: Patients with gastric cancer who underwent gastrectomy at Beijing Cancer Hospital from March 2017 to April 2018 were enrolled in the training set. Complications were prospectively registered. Receiver operating characteristic analysis was performed to assess the diagnostic accuracy of CRP via evaluating the area under the curve (AUC). Patients who had CRP tested on postoperative day (POD) 5 and accepted gastrectomy from April to December 2018 were included in the validation set to validate the cut-off value of CRP obtained from the training set. Results: A total of 350 patients were included (263 patients in the training set and 87 patients in the validation set). Out of these, 24 patients were diagnosed with infectious complications and 17 patients had anastomotic leakage in the training set. The CRP level on POD5 had superior diagnostic accuracy for infectious complications with an AUC of 0.81. The cut-off value of CRP on POD5 at 166.65 mg/L yielded 93% specificity and 97.2% negative predict value (NPV); For anastomotic leakage, the AUC of CRP on POD5 was 0.81. Using the cut-off value of CRP at 166.65 mg/L on POD5 achieved 92% specificity and 98.6% NPV. The optimal cut-off value (CRP 166.65 mg/L on POD5) was validated in the validation set. It achieved 97.5% specificity and 94.0% NPV for infectious complications, and 97.6% specificity and 96.4% NPV for anastomotic leakage. Conclusion: CRP is a reliable predictive marker for the diagnosis of inflammatory complications following gastric surgery. However, this study was based on preliminary data. The validity of this data needs confirmation by a larger number of cases.

Monitoring c-reactive protein after laparoscopic colorectal surgery excludes infectious complications and allows for safe and early discharge

2014 ◽  
Vol 28 (10) ◽  
pp. 2939-2948 ◽  
Author(s):  
Michel Adamina ◽  
Rene Warschkow ◽  
Franziska Näf ◽  
Bianka Hummel ◽  
Thomas Rduch ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Early Discharge ◽  
Infectious Complications ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Usefulness of Presepsin for the Early Detection of Infectious Complications after Elective Colorectal Surgery, Compared with C-Reactive Protein and Procalcitonin

2021 ◽  
Author(s):  
Erika Amanai ◽  
Kishiko Nakai ◽  
Junichi Saito ◽  
Eiji Hashiba ◽  
Takuya Miura ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Early Detection ◽  
Postoperative Mortality ◽  
Clinical Problem ◽  
Diagnostic Value ◽  
Infectious Complications ◽  
Infected Group ◽  
C Reactive Protein ◽  
Elective Colorectal Surgery ◽  
Reactive Protein

Abstract Background: Infectious complications remain a major clinical problem in colorectal surgery, contributing to prolonged hospital stays, additional costs and significant postoperative mortality. Presepsin has been reported to be a useful marker to diagnose sepsis, similar or superior to procalcitonin (PCT) and C-reactive protein (CRP), and plasma presepsin concentrations are associated with the severity of sepsis and its outcome. The aim of this study was to assess the diagnostic value of presepsin in the early detection of infectious complications after elective colorectal surgery, compared with CRP and PCT.Methods: This study was a prospective observational study. Patients of age >18 who underwent elective colon resections were enrolled and patients with end-stage kidney disease were excluded. Blood samples were collected just before surgery and on postoperative day (POD) 1, 2, 3, 4, and 6. Infectious complications were diagnosed by surgeons. Results: A total of 114 patients were examined, and 27 patients (23.7%) developed infectious complications: 11 anastomotic leaks, 13 intra-abdominal infections, and 3 wound infections. CRP and PCT markedly increased from POD1 to POD3 and then gradually decreased toward POD6 in both groups, but the trends of the decrease in the infected group were blunt, compared with those in the non-infected group. On the other hand, presepsin did not show major changes just after surgery, but it increased on POD4 and POD6, when the complications occurred. ROC analysis to predict infectious complications revealed that the best accuracy was obtained on POD 6 for all biomarkers. CRP showed excellent predictability and presepsin showed good predictability. However, the cut-off values of all biomarkers were relatively lower than expected. Conclusions: The trends of change in presepsin following colorectal surgeries were distinct from those of CRP and PCT. Monitoring the presepsin trends after colorectal surgeries could be helpful to detect postoperative infectious complications.Trial registration: UMIN000025313. Registered on 17 December 2016.

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