McSorley Stephen T, Ramanathan Michelle L, Horgan Paul G, McMillan Donald C
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Alexandra Parade, Glasgow, G4 0SF, UK,
Int J Colorectal Dis. 2015 Jul;30(7):913-7. doi: 10.1007/s00384-015-2229-3. Epub 2015 Apr 29.
Studies have shown that postoperative serum C-reactive protein (CRP) measurement may be useful in predicting the type of complication, infective or otherwise, following surgery for colorectal cancer. It may be that the magnitude of the postoperative CRP is also associated with the severity of the complication. The aim of the present study was to examine the relationship between daily postoperative CRP concentrations and Clavien-Dindo complication grade.
Data was recorded prospectively for patients undergoing elective, potentially curative, surgery for colorectal cancer in two hospitals between January 2011 and January 2013, n = 241. All patients had daily CRP measurement following surgery for the first four postoperative days. Complications were retrospectively classified by Clavien-Dindo grade.
Of the 241 patients, the majority were male (59%) and were over 65 years old (69%). The majority had colonic (86%) and node negative (65%) disease. One hundred nineteen patients (49%) developed a complication, and 28 (12%) of these were Clavien-Dindo grade 3, 4 or 5. Median and established threshold CRP concentrations on postoperative days 2 (>190 mg/L), 3 (>170 mg/L) and 4 (>125 mg/L) were directly associated with an increase in the Clavien-Dindo grade (all p < 0.001).
There was a direct association between exceeding established postoperative day 2, 3 and 4 CRP thresholds and the severity of complications defined by the Clavien-Dindo grade.
研究表明，术后血清C反应蛋白（CRP）检测可能有助于预测结直肠癌手术后并发症的类型，无论是感染性还是其他类型。术后CRP的数值可能也与并发症的严重程度相关。本研究的目的是探讨术后每日CRP浓度与Clavien-Dindo并发症分级之间的关系。
前瞻性记录2011年1月至2013年1月期间在两家医院接受择期、潜在根治性结直肠癌手术患者的数据，n = 241。所有患者术后前四天每天检测CRP。并发症通过Clavien-Dindo分级进行回顾性分类。
241例患者中，大多数为男性（59%），年龄超过65岁（69%）。大多数患者患有结肠癌（86%）且淋巴结阴性（65%）。119例患者（49%）出现并发症，其中28例（12%）为Clavien-Dindo 3、4或5级。术后第2天（>190 mg/L）、第3天（>170 mg/L）和第4天（>125 mg/L）的中位数及既定阈值CRP浓度与Clavien-Dindo分级的增加直接相关（所有p < 0.001）。
术后第2天、第3天和第4天CRP超过既定阈值与Clavien-Dindo分级所定义的并发症严重程度之间存在直接关联。
