Key result
Preoperative CRP of 3-10 mg/L linked to ~150% higher long-term mortality after nonemergent CABG.
Why the study?
The predictive value of preoperative CRP levels less than 10 mg/l for long-term mortality and hospital length of stay after primary, nonemergent CABG was unclear.
Does elevated preoperative CRP (≥3 mg/l) predict long-term mortality and extended hospital length of stay in patients undergoing primary, nonemergent CABG?
Cohort (n=914)
Does elevated preoperative CRP (≥3 mg/l) predict long-term mortality and extended hospital length of stay in patients undergoing primary, nonemergent CABG?
Hazard Ratio: 2.5 (95% CI 1.22–5.16)
p-value: p=0.01
Preoperative CRP levels as low as 3 mg/l are associated with increased long-term mortality and extended hospital length of stay in patients undergoing nonemergent CABG, allowing for better risk stratification.
Low preoperative CRP may aid mortality and LOS prediction after CABG; leaves open incremental value beyond standard risk models in prospective studies.
BACKGROUND: Preoperative C-reactive protein (CRP) levels more than 10 mg/l have been shown to be associated with increased morbidity and mortality after cardiac surgery. We examine the value of preoperative CRP levels less than 10 mg/l for predicting long-term, all-cause mortality and hospital length of stay in surgical patients undergoing primary, nonemergent coronary artery bypass graft-only surgery. METHODS: We examined the association between preoperative CRP levels stratified into four categories (< 1, 1-3, 3-10, and > 10 mg/l), and 7-yr all-cause mortality and hospital length of stay in 914 prospectively enrolled primary, nonemergent coronary artery bypass graft-only surgical patients using a proportional hazards regression model. RESULTS: Eighty-seven patients (9.5%) died during a mean follow-up period of 4.8 +/- 1.5 yr. After proportional hazards adjustment, the 3-10 and > 10 mg/l preoperative CRP groups were associated with long-term, all-cause mortality (hazards ratios [95% CI]: 2.50 [1.22-5.16], P = 0.01 and 2.66 [1.21-5.80], P = 0.02, respectively) and extended hospital length of stay (1.32 [1.07-1.63], P < 0.001 and 1.27 [1.02-1.62], P = 0.001, respectively). CONCLUSION: We demonstrate that preoperative CRP levels as low as 3 mg/l are associated with increased long-term mortality and extended hospital length of stay in relatively lower-acuity patients undergoing primary, nonemergent coronary artery bypass graft-only surgery. These important findings may allow for more objective risk stratification of patients who present for uncomplicated surgical coronary revascularization.
No takes yet. Share an insight, caveat, or question.
Perry et al. (2010) conducted a cohort in Primary, nonemergent coronary artery bypass graft-only surgery (n=914). Preoperative C-reactive protein (CRP) levels 3-10 mg/l vs. Preoperative CRP levels < 1 mg/l was evaluated on Long-term all-cause mortality (HR 2.50, 95% CI 1.22-5.16, p=0.01). Preoperative CRP levels of 3-10 mg/L were associated with increased long-term all-cause mortality (HR 2.50; 95% CI 1.22-5.16; P=0.01) in patients undergoing primary, nonemergent CABG.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: