Predictive value of C-reactive protein in critically ill patients after abdominal surgery
Clinics
;
72(1): 23-29, Jan. 2017. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-840029
ABSTRACT
OBJECTIVES:
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.METHODS:
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 theiroutcome:
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.RESULTS:
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.CONCLUSIONS:
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.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Proteína C-Reactiva
/
Sepsis
/
Abdomen
Tipo de estudio:
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Clinics
Asunto de la revista:
Medicina
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
Bélgica
Institución/País de afiliación:
Université Libre de Bruxelles/BE
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