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Pre- and postoperative C-reactive protein as a risk factor of organ/space surgical site infection after hepatectomy. | LitMetric

AI Article Synopsis

  • Organ/space surgical site infections (SSIs) are common complications after liver surgery, affecting patient recovery and mortality, hence identifying high-risk patients early is crucial.
  • This study analyzed hospital records of patients who had liver surgeries between 2008 and 2015 to see if pre- and postoperative C-reactive protein (CRP) levels could predict SSIs.
  • Results showed that higher preoperative CRP levels and a significant increase in CRP from postoperative day 3 to 5 were linked to a greater risk of SSIs, with specific factors like bile leakage and preoperative cholangitis playing important roles.

Article Abstract

Background: Organ/space surgical site infection (SSI) is one of the most common complications of liver resection, with significant impact on morbidity and mortality, so patients at high risk should be identified early. This study aimed to determine whether pre- and postoperative C-reactive protein (CRP) levels could predict organ/space SSIs.

Methods: The hospital records of consecutive patients who underwent hepatectomy without biliary reconstruction at our institutions between 2008 and 2015 were reviewed retrospectively. Preoperative, intraoperative, and postoperative variables were compared between patients with or without organ/space SSIs. Its risk factors were also determined.

Results: Among 443 identified patients, 55 cases (12.5%) developed organ/space SSIs; they more frequently experienced other complications and bile leakage (47.3% vs. 16.6%, p = 0.001; 40.0% vs. 8.5%, p < 0.001, respectively). Postoperative CRP elevation from postoperative day (POD) 3 to 5 was significantly more frequent in the SSI group (21.8% vs. 4.9%, p < 0.001). Multivariate analysis identified preoperative CRP ≥ 0.2 mg/dL (odds ratio (OR), 2.01, p = 0.044], preoperative cholangitis (OR, 15.7; p = 0.020), red cell concentrate (RCC) transfusion (OR, 2.61, p = 0.018), bile leakage (OR, 9.51; p < 0.001), and CRP level elevation from POD 3 to 5 (OR, 3.81, p = 0.008) as independent risk factors for organ/space SSIs.

Conclusions: Preoperative CRP elevation and postoperative CRP trajectory are risk factors for organ/space SSIs after liver resection. A prolonged CRP level elevation at POD 5 indicates its occurrence. If there were no risk factors and no CRP elevation at POD 5, its presence could be excluded.

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Source
http://dx.doi.org/10.1007/s00423-023-02760-4DOI Listing

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