C-reactive protein levels predict postoperative septic complications
R. A. Mustard Jr, J. M. Bohnen, S. Haseeb and R. Kasina
We studied 108 patients undergoing clean-contaminated and dirty surgical
procedures to determine whether daily C-reactive protein (CRP) measurements
for 14 days postoperatively could predict the occurrence of septic
complications prior to clinical diagnosis. Diagnostic criteria for septic
complications and positive CRP response were defined in advance of the
study. The CRP assays were carried out using an automated laser
nephelometer system after the patient's discharge from the hospital.
Forty-six septic complications were diagnosed in 40 patients. These
complications consisted of wound infection (23), urinary tract infection
(11), pneumonia (six), upper respiratory tract infection (three),
intra-abdominal abscess (one), and other (two). The CRP testing was found
to have a positive predictive value of 69% and a negative predictive value
of 78%. We conclude that serial CRP measurements may be a valuable adjunct
to surgical care in patients at high risk of postoperative septic
complications.
