Predictive value of perioperative procalcitonin, C reactive protein and high-sensitivity C reactive protein for the risk of postoperative complications after non-cardiac surgery in elderly patients: a nested case-control study.
adult anaesthesia
adult surgery
clinical trials
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
13 10 2023
13 10 2023
Historique:
medline:
23
10
2023
pubmed:
14
10
2023
entrez:
13
10
2023
Statut:
epublish
Résumé
Little is known about the correlation between perioperative concentrations of inflammatory biomarkers and postoperative complications. This study explored whether the plasma concentrations and perioperative changes of procalcitonin (PCT), C reactive protein (CRP) and high-sensitivity CRP (hsCRP) could predict the risk of postoperative morbidity in elderly patients undergoing elective non-cardiac surgery. A nested case-control study. A tertiary hospital in China. A total of 498 patients aged ≥65 years from a prospective cohort who underwent elective non-cardiac surgery between June 2020 and April 2021. The primary outcomes were the efficacy of plasma concentrations of PCT, CRP and hsCRP in predicting the risk of Clavien-Dindo Classification (CDC) ≥grade 3 and major complications. The major complications included mortality, an intensive care unit stay length >24 hour, cardiovascular events, acute kidney injury, postoperative cognitive dysfunction and infections. For major complications, the area under the curve (AUC) (95% CI) of PCT-24 hours, PCT change and PCT change rate were 0.750 (0.698 to 0.803), 0.740 (0.686 to 0.795) and 0.711 (0.651 to 0.771), respectively. The AUC (95% CI) of CRP-24 hours, CRP change, CRP change rate and hsCRP baseline were 0.835 (0.789 to 0.881), 0.818 (0.770 to 0.867), 0.691 (0.625 to 0.756) and 0.616 (0.554 to 0.678), respectively. For complications ≥CDC grade 3, the AUC (95% CI) of PCT-24 hours, PCT change and PCT change rate were 0.662 (0.543 to 0.780), 0.643 (0.514 to 0.772) and 0.627 (0.494 to 0.761), respectively. The AUC (95% CI) of CRP-24 hours and hsCRP baseline were 0.649 (0.527 to 0.771) and 0.639 (0.530 to 0.748), respectively. PCT-24 hours, CRP-24 hours, the change of perioperative PCT and CRP were valuable predictors of major complications occurring within 30 days after non-cardiac surgery in the elderly. China Clinical Trial Registry: ChiCTR1900026223.
Identifiants
pubmed: 37832985
pii: bmjopen-2022-071464
doi: 10.1136/bmjopen-2022-071464
pmc: PMC10583102
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Procalcitonin
0
Calcitonin
9007-12-9
Biomarkers
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e071464Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Circulation. 2003 Jan 28;107(3):363-9
pubmed: 12551853
J Intensive Care. 2014 Jun 03;2:35
pubmed: 25960877
Pharmacotherapy. 2005 Nov;25(11):1566-91
pubmed: 16232020
Eur Heart J. 2021 Jan 1;42(1):113-131
pubmed: 32176778
Br J Anaesth. 2019 Aug;123(2):196-205
pubmed: 31104758
EJIFCC. 2009 Jan 20;19(4):203-11
pubmed: 27683318
Surg Oncol. 2010 Sep;19(3):124-30
pubmed: 20004566
Anaesthesia. 2020 Jan;75 Suppl 1:e46-e53
pubmed: 31903565
Intensive Care Med. 2002 Aug;28(8):1094-102
pubmed: 12185431
Minerva Anestesiol. 2015 Jun;81(6):684-96
pubmed: 25057935
Clin J Am Soc Nephrol. 2009 May;4(5):873-82
pubmed: 19406962
Eur J Surg Oncol. 2008 Jul;34(7):727-9
pubmed: 18356004
Lancet Psychiatry. 2015 Nov;2(11):1002-12
pubmed: 26544749
Arterioscler Thromb Vasc Biol. 2003 Apr 1;23(4):650-5
pubmed: 12692007
Front Med (Lausanne). 2021 Sep 27;8:679260
pubmed: 34646835
Lancet. 2018 Jan 6;391(10115):59-69
pubmed: 29107324
J Am Geriatr Soc. 2003 Jul;51(7 Suppl):S351-4
pubmed: 12823667
J R Soc Med. 2007 Nov;100(11):508-12
pubmed: 18048708
Crit Care. 2006;10(5):R145
pubmed: 17038199
JMIR Public Health Surveill. 2022 Mar 2;8(3):e33191
pubmed: 34963658
J Clin Invest. 2011 Nov;121(11):4210-21
pubmed: 22045571
J Gen Intern Med. 2006 Feb;21(2):177-80
pubmed: 16606377
Ann Surg. 2013 Jan;257(1):27-36
pubmed: 22836216
Anesthesiology. 2021 Apr 1;134(4):552-561
pubmed: 33592096
Curr Opin Crit Care. 2015 Aug;21(4):322-7
pubmed: 26126130
Clin Transplant. 2015 Aug;29(8):689-96
pubmed: 25996831
Ann Intern Med. 2004 Jan 6;140(1):9-17
pubmed: 14706967
Lancet. 2019 Feb 2;393(10170):401
pubmed: 30722955
Scand J Surg. 2017 Dec;106(4):318-324
pubmed: 28737097
J Gastrointest Surg. 2023 Mar;27(3):478-488
pubmed: 36509900
Crit Care Med. 2001 Feb;29(2):323-5
pubmed: 11246313
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Chin Med J (Engl). 2017 May 20;130(10):1175-1181
pubmed: 28485317
Front Surg. 2022 Apr 28;9:902108
pubmed: 35574553
Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):849-856
pubmed: 35652864
Angiology. 2015 Nov;66(10):957-63
pubmed: 25688117
PLoS One. 2015 Jul 15;10(7):e0132995
pubmed: 26177542
Crit Care Med. 2000 Sep;28(9):3171-6
pubmed: 11008977
Ann Med. 2000 May;32(4):274-8
pubmed: 10852144
Anesthesiology. 2020 Jan;132(1):180-204
pubmed: 31687986
Ann Thorac Surg. 2011 Jun;91(6):1775-9
pubmed: 21531378
Curr Opin Anaesthesiol. 2014 Feb;27(1):89-97
pubmed: 24300462
Transplantation. 2009 Jul 27;88(2):279-87
pubmed: 19623026
Lancet. 2019 Nov 23;394(10212):1949-1964
pubmed: 31777389
Intensive Care Med. 2000 Sep;26(9):1259-67
pubmed: 11089751
Age Ageing. 2012 Mar;41(2):142-7
pubmed: 22345294
J Card Surg. 2008 Sep-Oct;23(5):468-73
pubmed: 18928484
Blood Purif. 2017;43(4):290-297
pubmed: 28125806
Nat Rev Endocrinol. 2018 Oct;14(10):576-590
pubmed: 30046148
Circulation. 2002 Mar 5;105(9):1135-43
pubmed: 11877368
Clin J Am Soc Nephrol. 2006 Jan;1(1):19-32
pubmed: 17699187
Acta Anaesthesiol Scand. 2003 Nov;47(10):1276-83
pubmed: 14616327
Circulation. 2003 Jul 29;108(4):414-9
pubmed: 12860911
J Anesth. 2018 Feb;32(1):112-119
pubmed: 29279996
Anesth Analg. 2018 Mar;126(3):1058-1067
pubmed: 28922235
Thorac Cardiovasc Surg. 2003 Dec;51(6):322-6
pubmed: 14669128
Intensive Care Med. 1998 Jul;24(7):680-4
pubmed: 9722037