Pre-operative C-reactive Protein as A Predictor of Hospital Length of Stay after Coronary Artery Bypass Grafting

Background: Coronary artery bypass grafting (CABG), the most frequently conducted cardiac surgery, triggers a significant postoperative inflammatory response, making C-reactive protein (CRP) a potentially valuable biomarker for predicting postoperative outcomes. Aim: To evaluate preoperative CRP as a predictor of hospital length of stay (LOS) following CABG. Patients and Methods: This prospective research was performed on 100 cases of elective on- or off-pump CABG at Cairo University Hospitals. Patients with emergency surgery, concomitant cardiac procedures, redo CABG, malignancy, autoimmune disorders, or signs of active infection were excluded. CRP concentration was determined preoperatively and on postoperative days 1, 3, and 5. The primary endpoint was hospital LOS; secondary endpoints included ICU stay and postoperative complications. Results: Preoperative CRP showed a strong positive association with hospital LOS (r = 0.54, p < 0.001) and ICU stay (r = 0.53, p < 0.001). Postoperative CRP levels on days 1, 3, and 5 also correlated significantly with both LOS and ICU stay, with day-5 CRP showing the strongest association (r = 0.65, p < 0.001). Cases with elevated preoperative CRP experienced significantly longer hospital stays (p = 0.009) and higher wound infection rates (20.3%, p = 0.026). insignificant association was detected between CRP level and new-onset atrial fibrillation or mortality. Conclusion: Preoperative CRP is a valuable predictor of prolonged hospital and ICU stay after CABG. Elevated CRP levels also increase the risk of postoperative wound infection. CRP may act as a useful biomarker for risk stratification and perioperative decision-making.