INTRODUCTION: C-reactive protein (CRP) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. CRP measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients. PATIENTS AND METHODS: General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. CRP results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted. RESULTS: CRP was requested pre-operatively on 84% of patients. A high CRP was more likely to be found in patients with co-morbidity. Postoperatively, CRP was requested during the first 3 days on 69% of patients. CRP peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative CRP, the peak CRP was higher and occurred later, than those who had a normal pre-operative CRP. CONCLUSIONS: CRP requesting pre-operatively is common, but is not recommended in NICE guidelines. Postoperatively, CRP levels rise; as a result, its use as a tool to screen for infection is limited. CRP has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of CRP measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative CRP should only be requested if there is a clear clinical indication.
INTRODUCTION:C-reactive protein (CRP) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. CRP measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients. PATIENTS AND METHODS: General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. CRP results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted. RESULTS:CRP was requested pre-operatively on 84% of patients. A high CRP was more likely to be found in patients with co-morbidity. Postoperatively, CRP was requested during the first 3 days on 69% of patients. CRP peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative CRP, the peak CRP was higher and occurred later, than those who had a normal pre-operative CRP. CONCLUSIONS:CRP requesting pre-operatively is common, but is not recommended in NICE guidelines. Postoperatively, CRP levels rise; as a result, its use as a tool to screen for infection is limited. CRP has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of CRP measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative CRP should only be requested if there is a clear clinical indication.
Authors: J Takahashi; S Ebara; M Kamimura; T Kinoshita; H Itoh; Y Yuzawa; Y Sheena; K Takaoka Journal: Spine (Phila Pa 1976) Date: 2001-08-01 Impact factor: 3.468
Authors: Jonathan Barnes; Jennifer Hunter; Steve Harris; Manu Shankar-Hari; Elisabeth Diouf; Ib Jammer; Cor Kalkman; Andrew A Klein; Tomas Corcoran; Stefan Dieleman; Michael P W Grocott; Michael G Mythen Journal: Br J Anaesth Date: 2019-02-14 Impact factor: 9.166
Authors: Chase T Schultz-Swarthfigure; Philip McCall; Robert Docking; Helen F Galley; Benjamin Shelley Journal: Interact Cardiovasc Thorac Surg Date: 2021-01-22