PURPOSE: Studies have shown that postoperative serum C-reactive protein (CRP) measurement may be useful in predicting the type of complication, infective or otherwise, following surgery for colorectal cancer. It may be that the magnitude of the postoperative CRP is also associated with the severity of the complication. The aim of the present study was to examine the relationship between daily postoperative CRP concentrations and Clavien-Dindo complication grade. PATIENTS AND METHODS: Data was recorded prospectively for patients undergoing elective, potentially curative, surgery for colorectal cancer in two hospitals between January 2011 and January 2013, n = 241. All patients had daily CRP measurement following surgery for the first four postoperative days. Complications were retrospectively classified by Clavien-Dindo grade. RESULTS: Of the 241 patients, the majority were male (59%) and were over 65 years old (69%). The majority had colonic (86%) and node negative (65%) disease. One hundred nineteen patients (49%) developed a complication, and 28 (12%) of these were Clavien-Dindo grade 3, 4 or 5. Median and established threshold CRP concentrations on postoperative days 2 (>190 mg/L), 3 (>170 mg/L) and 4 (>125 mg/L) were directly associated with an increase in the Clavien-Dindo grade (all p < 0.001). CONCLUSION: There was a direct association between exceeding established postoperative day 2, 3 and 4 CRP thresholds and the severity of complications defined by the Clavien-Dindo grade.
PURPOSE: Studies have shown that postoperative serum C-reactive protein (CRP) measurement may be useful in predicting the type of complication, infective or otherwise, following surgery for colorectal cancer. It may be that the magnitude of the postoperative CRP is also associated with the severity of the complication. The aim of the present study was to examine the relationship between daily postoperative CRP concentrations and Clavien-Dindo complication grade. PATIENTS AND METHODS: Data was recorded prospectively for patients undergoing elective, potentially curative, surgery for colorectal cancer in two hospitals between January 2011 and January 2013, n = 241. All patients had daily CRP measurement following surgery for the first four postoperative days. Complications were retrospectively classified by Clavien-Dindo grade. RESULTS: Of the 241 patients, the majority were male (59%) and were over 65 years old (69%). The majority had colonic (86%) and node negative (65%) disease. One hundred nineteen patients (49%) developed a complication, and 28 (12%) of these were Clavien-Dindo grade 3, 4 or 5. Median and established threshold CRP concentrations on postoperative days 2 (>190 mg/L), 3 (>170 mg/L) and 4 (>125 mg/L) were directly associated with an increase in the Clavien-Dindo grade (all p < 0.001). CONCLUSION: There was a direct association between exceeding established postoperative day 2, 3 and 4 CRP thresholds and the severity of complications defined by the Clavien-Dindo grade.
Authors: Rene Warschkow; Ulrich Beutner; Thomas Steffen; Sascha A Müller; Bruno M Schmied; Ulrich Güller; Ignazio Tarantino Journal: Ann Surg Date: 2012-08 Impact factor: 12.969
Authors: Matthias W Wichmann; Thomas P Hüttl; Hauke Winter; Fritz Spelsberg; Martin K Angele; Markus M Heiss; Karl-Walter Jauch Journal: Arch Surg Date: 2005-07
Authors: Graeme J K Guthrie; Kellie A Charles; Campbell S D Roxburgh; Paul G Horgan; Donald C McMillan; Stephen J Clarke Journal: Crit Rev Oncol Hematol Date: 2013-04-17 Impact factor: 6.312
Authors: Michelle L Ramanathan; Graham MacKay; Jonathan Platt; Paul G Horgan; Donald C McMillan Journal: Ann Surg Oncol Date: 2014-09-09 Impact factor: 5.344
Authors: Stephen T McSorley; Bo Y Khor; Graham J MacKay; Paul G Horgan; Donald C McMillan Journal: Medicine (Baltimore) Date: 2017-02 Impact factor: 1.889
Authors: Clemens Beck; Klaus Weber; Maximilian Brunner; Abbas Agaimy; Sabine Semrau; Robert Grützmann; Vera Schellerer; Susanne Merkel Journal: Int J Colorectal Dis Date: 2020-03-14 Impact factor: 2.571