Elevated preoperative C-reactive protein levels are a risk factor for the development of postoperative infectious complications following elective colorectal surgery

Abstract

The present study was designed to evaluate the relationship between the preoperative C-reactive protein levels and the incidence of postoperative infectious complications in patients undergoing colorectal surgery. This study was a retrospective cohort study of a consecutive series of 464 patients who underwent elective colorectal resection between April 2010 and March 2012. We evaluated the patients' preoperative conditions, including the preoperative C-reactive protein levels, surgical content, and incidence of postoperative infectious complications. Postoperative infectious complications occurred in 133 patients (28.7%). In the univariate analysis, male gender, rectal surgery, open surgery, elevated preoperative white blood cell counts, elevated preoperative C-reactive protein levels, extended operative times, large amounts of blood loss during surgery, and ostomy formation were found to be significantly associated with the incidence of postoperative infectious complications. In the multivariate analysis, elevated preoperative C-reactive protein levels (OR per mg/dl = 1.17, 95% CI = 1.02-1.37, P = 0.02) and large amounts of blood loss during surgery (OR per 100g = 1.13, 95% CI = 1.06-1.23, P < 0.01) were found to be independently associated with the incidence of postoperative infectious complications. This study provides evidence of an association between the preoperative C-reactive protein level and the incidence of postoperative infectious complications following colorectal surgery, which should be further confirmed in prospective and appropriately designed studies.