Title |
Predictive value of C-reactive protein in critically ill patients after abdominal surgery
|
---|---|
Published in |
Clinics, January 2017
|
DOI | 10.6061/clinics/2017(01)05 |
Pubmed ID | |
Authors |
Frédéric Sapin, Patrick Biston, Michael Piagnerelli |
Abstract |
The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. We included patients admitted to the ICU after abdominal surgery over a period of two years. The patients were divided into two groups according to their outcome: favorable (F; left the ICU alive, without modification of the antibiotic regimen) and unfavorable (D; death in the ICU, surgical revision with or without modification of the antibiotic regimen or just modification of the regimen). We then compared the highest C-reactive protein level on the first day of admission between the two groups. A total of 308 patients were included: 86 patients had an unfavorable outcome (group D) and 222 had a favorable outcome (group F). The groups were similar in terms of leukocytosis, neutrophilia, and platelet count. C-reactive protein was significantly higher at admission in group D and was the best predictor of an unfavorable outcome, with a sensitivity of 74% and a specificity of 72% for a threshold of 41 mg/L. No changes in C-reactive protein, as assessed based on the delta C-reactive protein, especially at days 4 and 5, were associated with a poor prognosis. A C-reactive protein cut-off of 41 mg/L during the first day of ICU admission after abdominal surgery was a predictor of an adverse outcome. However, no changes in the C-reactive protein concentration, especially by day 4 or 5, could identify patients at risk of death. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 52 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 9 | 17% |
Researcher | 7 | 13% |
Student > Master | 6 | 12% |
Student > Bachelor | 6 | 12% |
Student > Doctoral Student | 3 | 6% |
Other | 11 | 21% |
Unknown | 10 | 19% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 29 | 56% |
Nursing and Health Professions | 2 | 4% |
Social Sciences | 2 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Immunology and Microbiology | 1 | 2% |
Other | 3 | 6% |
Unknown | 14 | 27% |