title: Increased preoperative c-reactive protein level as a prognostic factor for postoperative amputation after femoropopliteal bypass surgery for CLI.
abstract: OBJECTIVE
  We evaluated the possible predictive role of C-reactive protein (CRP) on the immediate postoperative outcome after femoropopliteal bypass surgery for critical leg ischaemia (CLI).
  
  
  METHODS
  138 patients with CLI who underwent 143 femoropopliteal reconstructions.
  
  
  RESULTS
  The immediate postoperative period secondary patency rate was 87%, leg salvage rate was 94%, and survival rate 97%. Nine patients (6.3%) had 30-day postoperative major amputation, three of them despite a patent bypass graft because of progression of foot infection. The preoperative serum concentration of CRP was the only predictor of postoperative major amputation (p = 0.004; for an increase of 10 mg/l: OR, 1.188; CI 95%, 1.059-1.332). The median preoperative serum concentration of CRP among patients who did not have major amputation was 13.0 mg/l (range, 1-185), whereas it was 47.5 mg/l (range, 5-168) among those who had amputation after bypass graft occlusion, and 115.0 mg/l (range, 34-222) among those who had amputation despite a patent bypass graft (p = 0.008).
  
  
  CONCLUSIONS
  CRP may be a useful marker in risk stratification for postoperative amputation in patients undergoing femoropopliteal bypass surgery for CLI.
authors.affiliation: Department of Vascular Surgery, Helsinki University Central Hospital, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Mätzke
authors.forename: F
authors.initials: F
authors.lastname: Biancari
authors.forename: L
authors.initials: L
authors.lastname: Ihlberg
authors.forename: A
authors.initials: A
authors.lastname: Albäck
authors.forename: I
authors.initials: I
authors.lastname: Kantonen
authors.forename: M
authors.initials: M
authors.lastname: Railo
authors.forename: M
authors.initials: M
authors.lastname: Lepäntalo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery*; D011300:Preoperative Care; D011379:Prognosis
chemical_list: D002097:C-Reactive Protein