Clinical utility of peri-operative C-reactive protein testing in general surgery.
Ann R Coll Surg Engl
; 90(4): 317-21, 2008 May.
Article
en En
| MEDLINE
| ID: mdl-18492397
ABSTRACT
INTRODUCTION:
C-reactive protein (CRP) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. CRP measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients. PATIENTS ANDMETHODS:
General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. CRP results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted.RESULTS:
CRP was requested pre-operatively on 84% of patients. A high CRP was more likely to be found in patients with co-morbidity. Postoperatively, CRP was requested during the first 3 days on 69% of patients. CRP peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative CRP, the peak CRP was higher and occurred later, than those who had a normal pre-operative CRP.CONCLUSIONS:
CRP requesting pre-operatively is common, but is not recommended in NICE guidelines. Postoperatively, CRP levels rise; as a result, its use as a tool to screen for infection is limited. CRP has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of CRP measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative CRP should only be requested if there is a clear clinical indication.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Proteína C-Reactiva
/
Procedimientos Quirúrgicos Electivos
/
Complicaciones Intraoperatorias
Tipo de estudio:
Guideline
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann R Coll Surg Engl
Año:
2008
Tipo del documento:
Article
País de afiliación:
Reino Unido