Key result
Mean CRP levels 48-60 hours post-operatively were significantly higher in hip-fractured patients with complications compared to those without (20.9 vs 13.1 mg/dl, p=0.002).
Why the study?
Do CRP, fibrinogen, and ESR kinetics predict post-operative complications in aged patients operated on for hip fracture?
Cohort (n=32)
Do CRP, fibrinogen, and ESR kinetics predict post-operative complications in aged patients operated on for hip fracture?
CRP measurement 48-60 hours post-operatively in elderly hip fracture patients may be a valuable biomarker for assessing and monitoring complications.
BACKGROUND: Hip fracture is a frequent injury in the elderly, and is associated with a high incidence of functional impairment, complications and mortality. OBJECTIVE: To determine kinetics of C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) in hip-fractured patients over a 1-month post-operative period; to examine the relationship of these parameters to cognition, operation type, post-operational complications, functional level 1 month post-operatively and 6-month mortality. METHODS AND SUBJECTS: 32 aged patients operated on for hip fracture were prospectively followed-up for 6 months. Fracture, type of operation and anesthetic risk were recorded. Cognition was evaluated by the Mini-Mental State Examination and pre-fracture functional level evaluated by the Katz Index of ADL. Follow-up included complications, mortality and functional outcome. CRP, fibrinogen and ESR were assessed during the first 10 h post-fracture; 48-60 h, and 7 and 30 days post-operatively, respectively. RESULTS: Only CRP kinetics were found to differ in patients with complications vs. those without, as a group (p = 0.006), and in patients suffering infections, delirium and cardiovascular complication vs. patients with no complications (p = 0.06, 0.03, 0.02, respectively). Mean (+/-SEM) CRP 48-60 h post-operatively was 20.9 +/- 2.1 and 13.1 +/- 1.6 mg/dl in complicated and uncomplicated patients, respectively (p = 0.002). The mean CRP 48-60 h post-operatively was highly correlated with the CRP area under the curve, R = 0.88 (p < 0.001). A cut-off level of 15 mg/dl for CRP, 48- 60 h post-operatively, was calculated for patients with complications (sensitivity 93%, specificity 65%, p = 0.003). CRP, fibrinogen and ESR were not related to fracture or type of operation, cognition, anesthetic risk, 1-month post-operative functioning and 6-month mortality. CONCLUSIONS: CRP measurement in elderly patients operated for hip fracture may be valuable in assessing and monitoring complications.
No takes yet. Share an insight, caveat, or question.
Beloosesky et al. (2004) conducted a cohort in Hip fracture (n=32). Post-operative complications vs. No complications was evaluated on Mean CRP 48-60 h post-operatively (mg/dl) (p=0.002). Mean CRP levels 48-60 hours post-operatively were significantly higher in hip-fractured patients with complications compared to those without (20.9 vs 13.1 mg/dl, p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: