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Ann Thorac Surg 1999;67:134-138
© 1999 The Society of Thoracic Surgeons
a Department of Cardiopulmonary Surgery, University Hospital Maastricht, Maastricht, The Netherlands
b Department of Clinical Chemistry, University Hospital Maastricht, Maastricht, the Netherlands
Accepted for publication June 25, 1998.
Address reprint requests to Dr Maessen, Department of Cardiopulmonary Surgery, University Hospital Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
e-mail: jma{at}scpc.azm.nl
Background. We examined the possible predictive role of preoperative C-reactive protein (CRP) levels for postoperative infections in patients who have cardiac operations.
Methods. CRP levels were determined on the day before the operation and on postoperative days 1 to 4 and 6 in 593 consecutive patients. Furthermore, we documented infectious disease-related data.
Results. Patients in whom an infection developed during the postoperative course (n = 87) had significantly higher CRP levels on the day before operation (17.8 ± 3.9 mg/L compared with 7.7 ± 0.7 mg/L; p < 0.001) and on postoperative days 4 and 6. The incidence of postoperative infections was significantly higher in patients with increased preoperative CRP levels than in those with normal preoperative CRP levels (25.3% versus 11.2%, respectively; p < 0.001). Furthermore, patients with higher preoperative CRP levels had a significantly longer postoperative hospital stay than those with normal preoperative CRP levels (10.8 ± 1.2 days versus 7.8 ± 0.3 days; p < 0.001). Multivariate analysis, including classic risk factors and increased preoperative CRP levels, demonstrated that higher preoperative CRP was the most important variable predicting postoperative infection (odds ratio = 2.7; 95% confidence interval = 1.7 to 4.3; p < 0.001).
Conclusions. Patients with higher preoperative CRP levels are at increased risk for postoperative infections. Therefore, preoperative measurement of CRP might be a useful, predictive marker in risk stratification for postoperative infections in patients scheduled for cardiac operations.
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