Screening of concentrations of C-reactive protein and various plasma protease inhibitors preoperatively for the prediction of postoperative complications.
OBJECTIVE
To find out whether concentrations of albumin (reflecting nutritional state), C-reactive protein (reflecting an acute phase reaction) or plasma protease inhibitors (reflecting ongoing proteolysis) are good predictors of postoperative complications, and whether other biochemical tests may improve diagnostic accuracy.


METHODS
Retrospective study.


METHODS
University hospital, Sweden.


METHODS
260 patients undergoing elective surgery for malignant (n = 149) or benign (n = 111) disease.


METHODS
Preoperative biochemical plasma measurements and postoperative complications.


RESULTS
192 patients recovered uneventfully and 35 had minor and 33 major postoperative complications. An increased plasma C-reactive protein concentration preoperatively, as well as a reduced albumin concentration, predicted the risk of developing major postoperative complications. Measurement of plasma protease inhibitors (C1-esterase inhibitor, alpha-2-macroglobulin and antithrombin III), specific biochemical studies of microheterogeneity, or comparison of quantitative and functional concentrations of the inhibitors gave no additional information.


CONCLUSIONS
One measurement of the C-reactive protein and albumin concentrations preoperatively will identify patients at risk of developing severe postoperative complications.
Göransson
J
J
Department of Gynaecology and Experimental Research, Malmö University Hospital, Sweden.
Jonsson
S
S
Lasson
A
A
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D003174:Complement C1 Inactivator Proteins / Q000032:analysis; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011480:Protease Inhibitors / Q000097:blood*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D000511:alpha-Macroglobulins / Q000032:analysis
D003174:Complement C1 Inactivator Proteins; D011480:Protease Inhibitors; D012709:Serum Albumin; D000511:alpha-Macroglobulins; D000990:Antithrombin III; D002097:C-Reactive Protein