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Background: Serum C-reactive protein (CRP) is involved in the acute phase reaction after surgery, even though its clinical significance remains a matter of debate. We evaluated CRP levels in cardiac surgery patients without clinical or laboratory signs of infection.
Methods: We screened 737 consecutive patients referred to our center 8+/-5 days after cardiac surgery. Patients with fever (>37.2 degrees C), elevated white blood cell count (>11,000/ml), neutrophilia (>70%), or any inflammatory, infective or malignant disease were excluded. CRP levels were measured on admission and at discharge and the values were related to the following variables: age, sex, diabetes mellitus, renal failure, type of surgery, postoperative atrial fibrillation, pericardial or pleural effusion, and length of hospital stay. Follow-up (mean: 23+/-8.5 months) was available for 175 patients (94%).
Results: In the 187 patients enrolled in the study, the CRP values were significantly elevated (median: 4.23 mg/dl, interquartiles range: 2.68-6.64) independent of any variable analyzed. At discharge, CRP levels were significantly reduced compared with values on admission (median: 1.55 mg/dl, interquartiles range: 0.84-2.37, P<0.001). At follow-up, 19 events (10.8%) occurred (two noncardiac deaths, 17 hospital readmissions for cardiac reasons); nonetheless, no correlation was found with CRP values either on admission or at discharge.
Conclusion: Early after cardiac surgery, in patients without clinical or laboratory signs of acute infection, CRP levels are significantly elevated, do not correlate with clinical variables, and decrease at discharge. These findings suggest a systemic inflammatory response to surgery-related stress, which carries a favorable prognosis at follow-up.
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http://dx.doi.org/10.1097/HJR.0b013e328301a5eb | DOI Listing |
J Int Med Res
December 2024
Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, People's Republic of China.
Objective: This study aimed to compare the efficacy and safety of intravascular ultrasound (IVUS)-guided coronary intravascular lithotripsy and rotational atherectomy in treating severe coronary artery calcification.
Methods: A retrospective analysis of 60 patients who underwent percutaneous coronary intervention at the General Hospital of Ningxia Medical University from October 2022 to August 2023 was conducted. The patients were divided into two groups: 30 received IVUS-guided coronary intravascular lithotripsy and 30 underwent IVUS-guided rotational atherectomy.
J Int Med Res
December 2024
Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu, P.R. China.
Objective: This study retrospectively investigated the effects of different doses of dexmedetomidine combined with propofol on postoperative delirium in older adults undergoing cardiac surgery.
Methods: The medical records of 82 older adults undergoing cardiac surgery admitted to two hospitals between August 2019 and August 2022 were analyzed. The participants were divided into two groups based on the dexmedetomidine dose: group A (0.
J Bone Joint Surg Am
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: The purpose of this study was to report on 2-year results of vertebral body tethering (VBT), performed under a Food and Drug Administration protocol, to obtain insight into outcomes and complications.
Methods: Forty prospectively enrolled patients with adolescent idiopathic scoliosis (AIS) who had a Sanders score of ≤4 or a Risser score of ≤2 underwent VBT for curves between 40° and 70°. Surgical, radiographic, and patient-reported outcomes were reviewed at a minimum 2-year follow-up.
Eur J Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Objectives: In patients with interstitial lung disease (ILD), the diaphragm typically rises as the lungs chronically shrink. However, the grade of restriction differs in each patient. It is currently unknown, how disparities between actual and predicted recipient total lung capacity (TLC), impact changes in lung function parameters and long-term outcomes following lung transplantation (LTx).
View Article and Find Full Text PDFSpine Deform
December 2024
Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
Purpose: To assess the radiological outcomes and complications focusing on distal junctional failure (DJF) of adult spinal deformity patients who underwent thoracolumbar fixation with the use of offset sublaminar hooks (OSH) distally.
Methods: Retrospective review of a prospective, multicenter adult spinal deformity database (2 sites). Inclusion criteria were age of at least 18 years, presence of a spinal deformity with thoraco-lumbar instrumentation ending distally with OSH (pelvis excluded), with minimum 2 years of follow-up.
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