Abstract

BackgroundEarly detection of postoperative increase in C-reactive protein (CRP) correlates with postoperative complications. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early postoperative CRP level, for prophylactic management of postoperative complications in patients undergoing surgery under general anesthesia.Material and methodsMultivariate regression analysis was retrospectively performed to determine the independent factor of CRP levels on postoperative day (POD) 1 and to develop a prediction model. Validation of the prediction model was prospectively performed. Data from 316 adult patients on perioperative variables were retrospectively obtained in a training cohort in patients undergoing elective non-cardiac surgery. In a validation cohort, 88 patients undergoing mastectomy and 68 patients undergoing laparoscopic colon surgery were prospectively utilized to evaluate the value of the prediction model. Major complications after surgery were defined as the Clavien-Dindo grade IIIa or greater.ResultsDuration of surgery, mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative CRP level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001). In the validation cohort, the predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001). Receiver-operating characteristic curve analysis showed that the predicted CRP levels on POD1 was significantly associated with major complications after mastectomy (P = 0.0259) and laparoscopic colon surgery (P = 0.0049). The measured and predicted CRP levels significantly increased in the order of severity of postoperative complications (P < 0.01).ConclusionIncreases in duration of surgery, intraoperative nociceptive level and preoperative CRP level were selected to predict early increases in CRP level after non-cardiac surgery under general anesthesia. Predicted CRP levels on POD1 were likely associated with severity of postoperative complications.

Highlights

  • Diagnosis and treatment of postoperative complications is crucial for suppression of the associated morbidity and mortality

  • Mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative C-reactive protein (CRP) level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001)

  • The predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001)

Read more

Summary

Introduction

Diagnosis and treatment of postoperative complications is crucial for suppression of the associated morbidity and mortality. Since the preoperative and intraoperative factors associated with postoperative CRP changes would be correlated with postoperative complications, perioperative managements for controlling those preoperative and intraoperative factors are potentially significant in the prophylactic management of postoperative complications. To reveal the relationship between perioperative risk factors and early postoperative C-reactive protein levels, we developed and validated a prediction model for CRP levels on POD1 in training and validation cohorts in patients undergoing non-cardiac surgery in the present study. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early postoperative CRP level, for prophylactic management of postoperative complications in patients undergoing surgery under general anesthesia

Methods
Results
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.