• Toru Kubo, Satoshi Ono, Hideki Ueno, Eiji Shinto, Junji Yamamoto, and Kazuo Hase.
• Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan, drs1020@ndmc.ac.jp.
• Langenbecks Arch Surg. 2013 Oct 1;398(7):965-71.

PurposeThe present study was designed to evaluate the relationship between the preoperative C-reactive protein levels and the incidence of postoperative infectious complications in patients undergoing colorectal surgery.MethodsThis study was a retrospective cohort study of a consecutive series of 464 patients who underwent elective colorectal resection between April 2010 and March 2012. We evaluated the patients' preoperative conditions, including the preoperative C-reactive protein levels, surgical content, and incidence of postoperative infectious complications.ResultsPostoperative infectious complications occurred in 133 patients (28.7 %). In the univariate analysis, male gender, rectal surgery, open surgery, elevated preoperative white blood cell counts, elevated preoperative C-reactive protein levels, extended operative times, large amounts of blood loss during surgery, and ostomy formation were found to be significantly associated with the incidence of postoperative infectious complications. In the multivariate analysis, elevated preoperative C-reactive protein levels (OR per mg/dl = 1.17, 95 % CI = 1.02-1.37, P = 0.02) and large amounts of blood loss during surgery (OR per 100 g = 1.13, 95 % CI = 1.06-1.23, P < 0.01) were found to be independently associated with the incidence of postoperative infectious complications.ConclusionsThis study provides evidence of an association between the preoperative C-reactive protein level and the incidence of postoperative infectious complications following colorectal surgery, which should be further confirmed in prospective and appropriately designed studies.

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