C-reactive protein as a predictor of postoperative infective complications following elective colorectal resection.
OBJECTIVE
C-reactive protein (CRP) may be useful in predicting postoperative complications [1]. We investigated the sensitivity and specificity of postoperative CRP for infective complications after elective colorectal surgery.


METHODS
One hundred and sixty consecutive patients (72 years old; interquartile range, 63-79) undergoing elective resection for colorectal cancer treated between September 2003 and October 2006 were studied. Details of the postoperative course were prospectively entered into a database. Of the 160 patients, 10 had incomplete CRP data and were excluded from further analysis.


RESULTS
Infective complications occurred in 21%, with an overall complication rate of 29%. Infective complications occurred as follows: respiratory (10), wound (9), urinary tract (2) and central line infection (1), anastomotic leakage (5), intra-abdominal abscess (3) and septicaemia of unknown origin (2). There were three postoperative deaths. The positive predictive value for infection of CRP > 145 mg/l on postoperative day 4 was 61%. The negative predictive value of CRP < 145 mg/l on postoperative day 4 for an infective complication was 96%.


CONCLUSIONS
A CRP > 145 mg/l on day 4 has high specificity and sensitivity for infective complications following elective colorectal resection.
MacKay
G J
GJ
Department of General Surgery, Gartnavel General Hospital, Glasgow, UK. drgimac@hotmail.com
Molloy
R G
RG
O'Dwyer
P J
PJ
D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D003082:Colectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D015415:Biomarkers; D002097:C-Reactive Protein