Alberto Lopez-Pastorini1, Richard Riedel2, Aris Koryllos3, Frank Beckers4, Corinna Ludwig5, Erich Stoelben6. 1. Department of Thoracic Surgery, Lung Clinic Merheim, Hospital of the City of Cologne, University of Witten-Herdecke, Germany. Electronic address: alberto.lopez@uni-wh.de. 2. Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany. Electronic address: richard.riedel@uk-koeln.de. 3. Department of Thoracic Surgery, Lung Clinic Merheim, Hospital of the City of Cologne, University of Witten-Herdecke, Germany. Electronic address: koryllosa@kliniken-koeln.de. 4. Department of Thoracic Surgery,St. Vinzenz Hospital, Cologne, Germany. Electronic address: frank.beckers@cellitinnen.de. 5. Department of Thoracic Surgery, Florence Nightingale Hospital, Düsseldorf, Germany. Electronic address: ludwigc@kaiserswerther-diakonie.de. 6. Department of Thoracic Surgery, Lung Clinic Merheim, Hospital of the City of Cologne, University of Witten-Herdecke, Germany. Electronic address: StoelbenE@kliniken-koeln.de.
Abstract
INTRODUCTION: The aim of this study was to determine whether preoperative elevated serum C-reactive protein (CRP) is an independent risk factor of postoperative morbidity and mortality after pulmonary resection for lung cancer. MATERIAL AND METHODS: A retrospective analysis of prospectively collected data on 1414 consecutive patients that underwent an anatomic resection for lung cancer was performed. Patients' characteristics, operative procedures and the postoperative outcome were assessed with a standardised data entry form. Univariate and multivariate analyses were conducted to identify factors that affect morbidity and mortality. RESULTS: Postoperative complications occurred in 35.5% of the patients. The mortality rate was 3.2%. Patients with preoperative C-reactive protein above 40mg/l showed more overall complications and a higher mortality than patients below this limit. Patients with a CRP level between 3mg/l and 40mg/l had no significant increase in morbidity and mortality compared to patients with values below the detection limit (< 3mg/l). CONCLUSIONS: Preoperative serum C-reactive protein level is an independent and significant indicator for elevated morbidity and mortality after pulmonary resection. We propose the evaluation of CRP levels as a preoperative diagnostic modality of risk assessment in addition to standardised functional testing.
INTRODUCTION: The aim of this study was to determine whether preoperative elevated serum C-reactive protein (CRP) is an independent risk factor of postoperative morbidity and mortality after pulmonary resection for lung cancer. MATERIAL AND METHODS: A retrospective analysis of prospectively collected data on 1414 consecutive patients that underwent an anatomic resection for lung cancer was performed. Patients' characteristics, operative procedures and the postoperative outcome were assessed with a standardised data entry form. Univariate and multivariate analyses were conducted to identify factors that affect morbidity and mortality. RESULTS:Postoperative complications occurred in 35.5% of the patients. The mortality rate was 3.2%. Patients with preoperative C-reactive protein above 40mg/l showed more overall complications and a higher mortality than patients below this limit. Patients with a CRP level between 3mg/l and 40mg/l had no significant increase in morbidity and mortality compared to patients with values below the detection limit (< 3mg/l). CONCLUSIONS: Preoperative serum C-reactive protein level is an independent and significant indicator for elevated morbidity and mortality after pulmonary resection. We propose the evaluation of CRP levels as a preoperative diagnostic modality of risk assessment in addition to standardised functional testing.