Examination of a CRP first approach for the detection of postoperative complications in patients undergoing surgery for colorectal cancer: a pragmatic study (original) (raw)

Mcsorley, Stephen T. ORCID: https://orcid.org/0000-0002-5459-8445, Khor, Bo Y., MacKJay, Graham J., Horgan, Paul G. ORCID: https://orcid.org/0000-0001-5557-7905 and McMillan, Donald C. ORCID: https://orcid.org/0000-0003-4260-5334(2017) Examination of a CRP first approach for the detection of postoperative complications in patients undergoing surgery for colorectal cancer: a pragmatic study.Medicine, 96(7), e6133. (doi: 10.1097/MD.0000000000006133) (PMID:28207541)

Abstract

The aim of the present study was to examine whether a C-reactive protein (CRP) first approach would improve the detection rate of postoperative complications by CT. CRP is a useful biomarker to identify major complications following surgery for colorectal cancer. Patients with histologically confirmed colorectal cancer, who underwent elective surgery between 2008 and 2015 at a single centre were included. Exceeding the established CRP threshold of 150mg/L on postoperative day (POD) 4 was recorded. Results of CT performed between postoperative days 4 and 14 were recorded. Four hundred ninety-five patients were included. The majority were male (58%), over 65 (68%), with node-negative disease (66%) and underwent open surgery (70%). Those patients who underwent a CT scan (n=93), versus those who did not (n=402), were more likely to have a postoperative complication (84% vs 35%, P<0.001), infective complication (67% vs 21%, P<0.001), and anastomotic leak (17% vs 2%, P<0.001). In patients who did not undergo a CT scan (n=402) exceeding the CRP threshold (n=117) on POD 4 was associated with a higher rate of postoperative complication (50% vs 29%, P<0.001), infective complications (36% vs 15%, P<0.001), and anastomotic leak (4% vs 0.5%, P=0.009). In patients who did undergo a CT scan (n=93) exceeding the CRP threshold (n=53) on POD 4 was associated with earlier CT (median POD 6 vs 8, P=0.001) but not postoperative complications. A CRP first approach resulted in earlier and improved detection of complications by CT following surgery for colorectal cancer

University Staff: Request a correction | Enlighten Editors: Update this record

Deposit and Record Details