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The value of C-reactive protein, leucocytes and vital signs in detecting major complications after oncological colorectal surgery.
Gielen, Anke H C; Schoenmakers, Maud; Breukink, Stephanie O; Winkens, Bjorn; van der Horst, Jischmaël; Wevers, Kevin P; Melenhorst, Jarno.
Afiliação
  • Gielen AHC; Department of Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. anke.gielen@mumc.nl.
  • Schoenmakers M; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands. anke.gielen@mumc.nl.
  • Breukink SO; Department of Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
  • Winkens B; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
  • van der Horst J; Department of Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
  • Wevers KP; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
  • Melenhorst J; GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands.
Langenbecks Arch Surg ; 409(1): 76, 2024 Feb 27.
Article em En | MEDLINE | ID: mdl-38409295
ABSTRACT

PURPOSE:

To assess the association of postoperative C-reactive protein (CRP), leucocytes and vital signs in the first three postoperative days (PODs) with major complications after oncological colorectal resections in a tertiary referral centre for colorectal cancer in The Netherlands.

METHODS:

A retrospective cohort study, including 594 consecutive patients who underwent an oncological colorectal resection at Maastricht University Medical Centre between January 2016 and December 2020. Descriptive analyses of patient characteristics were performed. Logistic regression models were used to assess associations of leucocytes, CRP and Modified Early Warning Score (MEWS) at PODs 1-3 with major complications. Receiver operating characteristic curve analyses were used to establish cut-off values for CRP.

RESULTS:

A total of 364 (61.3%) patients have recovered without any postoperative complications, 134 (22.6%) patients have encountered minor complications and 96 (16.2%) developed major complications. CRP levels reached their peak on POD 2, with a mean value of 155 mg/L. This peak was significantly higher in patients with more advanced stages of disease and patients undergoing open procedures, regardless of complications. A cut-off value of 170 mg/L was established for CRP on POD 2 and 152 mg/L on POD 3. Leucocytes and MEWS also demonstrated a peak on POD 2 for patients with major complications.

CONCLUSIONS:

Statistically significant associations were found for CRP, Δ CRP, Δ leucocytes and MEWS with major complications on POD 2. Patients with CRP levels ≥ 170 mg/L on POD 2 should be carefully evaluated, as this may indicate an increased risk of developing major complications.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Cirurgia Colorretal Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Cirurgia Colorretal Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article