Authors: Cole, Duncan S.¹; Watts, Andrew¹; Scott-Coombes, David²; Avades, Tony¹

Source: Annals of The Royal College of Surgeons of England, Volume 90, Number 4, May 2008 , pp. 317-321(5)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: C-reactive protein (CRP) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. CRP measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients.

PATIENTS AND METHODS: General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. CRP results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted.

RESULTS: CRP was requested pre-operatively on 84% of patients. A high CRP was more likely to be found in patients with co-morbidity. Postoperatively, CRP was requested during the first 3 days on 69% of patients. CRP peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative CRP, the peak CRP was higher and occurred later, than those who had a normal pre-operative CRP.

CONCLUSIONS: CRP requesting pre-operatively is common, but is not recommended in NICE guidelines. Postoperatively, CRP levels rise; as a result, its use as a tool to screen for infection is limited. CRP has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of CRP measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative CRP should only be requested if there is a clear clinical indication.

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Keywords: C-REACTIVE PROTEIN; PERI-OPERATIVE MANAGEMENT; AUDIT; ELECTIVE SURGERY

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588408X285865

Affiliations: 1: Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK 2: Department of Surgery, University Hospital of Wales, Cardiff, UK

Publication date: 2008-05-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
  To view articles that have been published online ahead of print please click here
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