Acute Phase Reactants Predict the Risk of Amputation in Diabetic Foot Infection

2011 ◽  
Vol 101 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Baris Akinci ◽  
Serkan Yener ◽  
Sena Yesil ◽  
Nur Yapar ◽  
Yasin Kucukyavas ◽  
...  
Keyword(s):  
Acute Phase ◽  
Diabetic Foot ◽  
Post Treatment ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Protein Levels ◽  
Reactive Protein ◽  
Diabetic Foot Infections ◽  
Cell Counts ◽  
White Blood Cell Counts

Background: Prediction of amputation would aid clinicians in the management of diabetic foot infections. We aimed to assess the predictive value of baseline and post-treatment levels of acute phase reactants in the outcome of patients with diabetic foot infections. Methods: We collected data prospectively during minimum follow-up of 6 months in patients with infected diabetic foot ulcers hospitalized in Dokuz Eylul University Hospital between January 1, 2003, and January 1, 2008. After excluding patients who did not attend the hospital for follow-up visits regularly (n = 36), we analyzed data from 165 foot ulcer episodes. Results: Limb ischemia and osteomyelitis were much more frequent in patients who underwent amputation. Wagner grade, which assesses ulcer depth and the presence of osteomyelitis or gangrene, was higher in patients who needed amputation. Ulcer size was slightly larger in the amputation group. Baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, white blood cell counts, and platelet counts were significantly elevated in patients who underwent amputation. Albumin levels were significantly suppressed in the amputation group. Univariate analysis showed that a 1-SD increase in baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, and white blood cell counts and a 1-SD decrease in post-treatment albumin levels were significantly associated with increased risk of amputation. Post-treatment C-reactive protein level was strongly associated with amputation risk. Conclusions: Circulating levels of acute phase reactants were associated with amputation risk in diabetic foot infections. (J Am Podiatr Med Assoc 101(1): 1–6, 2011)

scholarly journals Combined C-Reactive Protein and Novel Inflammatory Parameters as a Predictor in Cancer—What Can We Learn from the Hematological Experience?

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1966 ◽  
Author(s):  
Øystein Bruserud ◽  
Helene Hersvik Aarstad ◽  
Tor Henrik Anderson Tvedt
Keyword(s):  
Acute Phase ◽  
Hematological Malignancies ◽  
Phase Reaction ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Inflammatory Parameters ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
White Blood Cell Counts

The acute phase reaction is a systemic response to acute or chronic inflammation. The serum level of C-reactive protein (CRP) is the only acute phase biomarker widely used in routine clinical practice, including its uses for prognostics and therapy monitoring in cancer patients. Although Interleukin 6 (IL6) is a main trigger of the acute phase reactions, a series of acute phase reactants can contribute (e.g., other members in IL6 family or IL1 subfamily, and tumor necrosis factor α). However, the experience from patients receiving intensive chemotherapy for hematological malignancies has shown that, besides CRP, other biomarkers (e.g., cytokines, soluble cytokine receptors, soluble adhesion molecules) also have altered systemic levels as a part of the acute phase reaction in these immunocompromised patients. Furthermore, CRP and white blood cell counts can serve as a dual prognostic predictor in solid tumors and hematological malignancies. Recent studies also suggest that biomarker profiles as well as alternative inflammatory mediators should be further developed to optimize the predictive utility in cancer patients. Finally, the experience from allogeneic stem cell transplantation suggests that selected acute phase reactants together with specific markers of organ damages are useful for predicting or diagnosing graft versus host disease. Acute phase proteins may also be useful to identify patients (at risk of) developing severe immune-mediated toxicity after anticancer immunotherapy. To conclude, future studies of acute phase predictors in human malignancies should not only investigate the conventional inflammatory mediators (e.g., CRP, white blood cell counts) but also combinations of novel inflammatory parameters with specific markers of organ damages.

scholarly journals Searching for methods to predict septic complications in surgical patients

2015 ◽  
Vol 96 (3) ◽  
pp. 294-297
Author(s):  
T Z Zakiev ◽  
S R Tuysin ◽  
A R Gil’fanov ◽  
R D Sagdiev ◽  
I V Zakieva
Keyword(s):  
Acute Phase ◽  
Albumin Level ◽  
Main Group ◽  
Water Soluble ◽  
Control Group ◽  
Study Group ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Cell Counts

Aim. To assess the significance of acute stage reactants as the marker for purulent complications in surgical patients.Methods. We analyzed the results of treatment of 228 patients with purulent and inflammatory diseases of soft tissues, treated in 2011-2014. Acute phase reactants: C-reactive protein, albumin and fibrinogen were measured starting from the day of admission and surgical treatment and during the next 7 days. The control group (112 patients) included patients whowere treated conventionally by gauze bandage with water-soluble ointments and antiseptic solutions and broad-spectrum antibiotics. In the study group (116 patients) topical treatment of wounds was performed using «Poliderm» bandages.Results. Application of the «Poliderm» combined dressing reduced the wounds clearance term from 4.3±0.5 to 3.2±0.4 days, active inflammation term from 8.8±1.3 to 6.4±0.7 days, epithelialization of the wound from 10.1±0.8 to 8.4±0.6 days. C-reactive protein level was 87.3±4.3 g/l at the day of admission and decreased by day 7 to 34.13±1.2 g/l, compared to 51.83±3.6 g/l on the 7th day in the control group. Albumin level was 42.73±3.7 g/l in the study group with further decrease to 40.33±1.7 g/l on the 2nd and subsequent increase up to 45.13±1.3 g/l on the day 7. Patients of the control group had albumin level decreased on the 2nd and 3rd days with further increase up to 41.73±2.1 g/l on the day 7. At the treatment start, leukocyte intoxication index was 5.923±0.4 in the main group and 5.873±0.3 in the control group. On the 2nd day, this parameter decreased to 5.12 in the main group and to 5.41 in the control group.Conclusion. Measuring the levels of acute phase reactants (C-reactive protein, albumin, etc.) allows to assess the clinical course of a purulent and inflammatory disease, to register the good treatment effect on the 1-2nd day of treatment, even before the significant clinical changes, changes in the body temperature, white blood cell counts, erythrocyte sedimentation rate.

Comparison of the Neutrophil/Lymphocyte Ratio and C-Reactive Protein Levels in Patients With Amputation for Diabetic Foot Ulcers

2017 ◽  
Vol 16 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Hasan Metineren ◽  
Turan Cihan Dülgeroğlu
Keyword(s):  
Diabetic Foot ◽  
Inflammatory Marker ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
C Reactive Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Protein Levels ◽  
Reactive Protein ◽  
Before And After

This study compared the effectiveness of the neutrophil/lymphocyte ratio (NLR) versus C-reactive protein (CRP) for evaluating the prognosis and degree of inflammation in patients with amputation for a diabetic foot ulcer (DFU). This study enrolled 56 patients with amputations for DFU with gangrene and compared the CRP levels and NLR measured before and after surgery. Overall, 24 patients (42%) died within 2 weeks postoperatively. Mortality increased with a preoperative/postoperative CRP difference ≤1.5 ( P < .001) and age 73 years or older ( P < .001). The postoperative NLR was lower than the preoperative value but was not significant as a prognostic or inflammatory marker ( P = .945). An increasing serum CRP level is a significant predictor of mortality. CRP and old age are reliable prognostic factors in patients with DFU.

scholarly journals Role of C-Reactive Protein, White Blood Cell Counts, Bilirubin Levels, and Imaging in the Diagnosis of Acute Appendicitis as a Cause of Right Iliac Fossa Pain

Cureus ◽  
2018 ◽  
Author(s):  
Shetty Sushruth ◽  
Chellappa Vijayakumar ◽  
Krishnamachari Srinivasan ◽  
Nagarajan Raj Kumar ◽  
Gopal Balasubramaniyan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Iliac Fossa ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Right Iliac Fossa Pain ◽  
White Blood Cell Counts
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