Markus Neumaier1, Michael A Scherer. 1. Department of Trauma and Reconstructive Surgery, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany. ma.neumaier@t-online.de
Abstract
BACKGROUND AND PURPOSE: For early detection of postoperative infections, the level of C-reactive protein (CRP) may be useful. We analyzed baseline and time-dependent reference values for the postoperative use of CRP as an indicator of infection. METHODS: We studied the kinetics of CRP levels after fracture surgery in 1,418 patients. In 787 cases the operative fracture treatment was uneventful; in 17 of the other cases a deep wound infection occurred. RESULTS: In the uneventful cases, a similar evolution in CRP concentrations was found: the peak level, which occurred on the second postoperative day, depended on the region (136 mg/L in femoral fractures and 45 mg/L in ankle fractures) and reflected the extent of surgical trauma. For deep wound infection, a cutoff level of 96 mg/L (sensitivity 92%, specificity 93%) after the fourth day of surgery was recorded. INTERPRETATION: CRP kinetics permit establishment of a time-dependent set of reference values of CRP after operative fracture treatment. Deviations of this course--especially CRP concentrations above 96 mg/L after the fourth day--may aid in early detection of surgical complications.
BACKGROUND AND PURPOSE: For early detection of postoperative infections, the level of C-reactive protein (CRP) may be useful. We analyzed baseline and time-dependent reference values for the postoperative use of CRP as an indicator of infection. METHODS: We studied the kinetics of CRP levels after fracture surgery in 1,418 patients. In 787 cases the operative fracture treatment was uneventful; in 17 of the other cases a deep wound infection occurred. RESULTS: In the uneventful cases, a similar evolution in CRP concentrations was found: the peak level, which occurred on the second postoperative day, depended on the region (136 mg/L in femoral fractures and 45 mg/L in ankle fractures) and reflected the extent of surgical trauma. For deep wound infection, a cutoff level of 96 mg/L (sensitivity 92%, specificity 93%) after the fourth day of surgery was recorded. INTERPRETATION:CRP kinetics permit establishment of a time-dependent set of reference values of CRP after operative fracture treatment. Deviations of this course--especially CRP concentrations above 96 mg/L after the fourth day--may aid in early detection of surgical complications.
Authors: Kyle J Kopechek; Gregory L Cvetanovich; Joshua S Everhart; Travis L Frantz; Richard Samade; Julie Y Bishop; Andrew S Neviaser Journal: HSS J Date: 2021-03-20
Authors: Klemens Horst; Frank Hildebrand; Roman Pfeifer; Karin Köppen; Philipp Lichte; Hans-Christoph Pape; Thomas Dienstknecht Journal: Eur J Med Res Date: 2015-01-14 Impact factor: 2.175