gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019)

22. - 25.10.2019, Berlin

C-reactive Protein for Early Detection of Postoperative Systemic Infections in Intertrochanteric Femoral Fractures

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Kuen Tak Suh - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Won Chul Shin - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Jung Sub Lee - Pusan National University Hospital, Busan, South Korea
  • Nam Hoon Moon - Pusan National University Hospital, Busan, South Korea
  • Seung Min Son - Pusan National University Yangsan Hospital, Yangsan, South Korea
  • Min Uk Do - Pusan National University Yangsan Hospital, Yangsan, South Korea

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019). Berlin, 22.-25.10.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocAB39-120

doi: 10.3205/19dkou307, urn:nbn:de:0183-19dkou3071

Veröffentlicht: 22. Oktober 2019

© 2019 Suh et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: This retrospective cohort study investigated perioperative C-reactive protein (CRP) value for early detection of postoperative systemic infective complications in elderly patients with intertrochanteric femoral fractures.

Methods: A total of 250 patients aged > 65 years, with intertrochanteric femoral fractures that were surgically treated between January 2011 and December 2015 were included. CRP value was measured preoperatively and on postoperative day (POD) 3, 5, and 10, and analyzed with regard to postoperative systemic infections, delirium, and death within 1 year. The patients were divided into two groups according to postoperative systemic infection, and perioperative CRP responses between the two groups were compared. The CRP threshold that maximized sensitivity and specificity for the detection of patients with systemic infections was identified. Systemic infections were reclassified as pulmonary and extra-pulmonary infections.

Results and conclusion: The mean CRP values preoperatively and on POD 3, 5, and 10 were 2.82, 10.10, 3.74, and 1.89 mg/dL, respectively. Postoperative systemic infections, delirium, and death within 1 year were noted in 35 (14.0%), 30 (12.0%), and 45 (18.0%) patients, respectively. The CRP value in patients with postoperative systemic infections significantly elevated on POD 5 and 10 (p < 0.001, p < 0.001), and cut-off values were 4.71 and 1.59 mg/dL on POD 5 and 10, respectively. Postoperative delirium and death within 1 year were observed more often in the group with postoperative systemic infections (p = 0.003, p = 0.014). Although preoperatively elevated CRP values did not influence the postoperative CPR responses, they were significantly associated with delirium (p = 0.015).

The CRP value on POD 5 is the earliest predictor of postoperative systemic infections in elderly patients with intertrochanteric femoral fractures that managed surgically. Moreover, when the CRP value on POD 5 is > 4.71 mg/dL, the possibility of postoperative systemic infections should be considered.