Serum C-reactive protein as a predictor of morbidity and mortality in intensive care unit patients after esophagectomy
Background: Serum C-reactive protein (CRP) is an acute-phase protein, synthesized during any proinflammatory response in the body. Preoperative elevation of serum CRP has been reported to be a prognostic indicator in oncologic surgery. The aim of this study was to investigate the value of postoperative serum CRP elevation as a prognostic parameter in patients undergoing elective esophagectomy followed by routine admission to the intensive care unit (ICU). Methods: In a prospective follow-up cohort study, data were collected of 63 patients admitted to the ICU after elective esophagectomy surgery from October 2007 to December 2008. Postoperative serum CRP levels were determined at the moment of admission to the ICU, 24, 48, and 72 hours postoperatively, and the relation with the development of complications and the 1-year survival status was investigated. Results: In postoperative esophagectomy patients admitted to the ICU, CRP levels at T24 and T48 were significantly higher in the patients who developed postoperative complications, which in itself was associated with lower 1-year survival. Conclusions: In patients undergoing esophagectomy with gastric tube reconstruction, increased CRP levels were associated with the occurrence of postoperative complications and higher 1-year mortality. Postoperative serum CRP levels can easily be monitored in the ICU in order to identify patients at risk for the development of postoperative complications; future research is needed to determine whether these complications can be prevented and improve outcome.