Pre-Surgery C-Reactive Protein Linked to Long-Term Mortality

Study finds significantly increased mortality with C-reactive protein levels 3 mg/L and higher
By Jeff Muise
HealthDay Reporter

MONDAY, March 8 (HealthDay News) -- Surgical patients undergoing primary, non-emergent coronary artery bypass graft-only surgery with elevated preoperative levels of C-reactive protein (CRP) are at heightened risk for longer hospital stays and long-term mortality, according to a study in the March issue of Anesthesiology.

Tjorvi E. Perry, M.D., of Brigham and Women's Hospital in Boston, and colleagues reviewed outcomes for 914 patients who had non-emergent coronary artery bypass surgery, and analyzed the association between serum CRP levels prior to surgery (stratified by level: less than 1 mg/L, 1 to 3 mg/L, 3 to 10 mg/L, and greater than 10 mg/L) with hospital length of stay and all-cause mortality up to seven years later.

The researchers found that a total of 87 patients (9.5 percent) died during the follow-up period (mean follow-up, 4.8 years), and higher levels of CRP were associated with increased risk of all-cause mortality. The all-cause mortality risks for 3 to 10 mg/L and greater than 10 mg/L CRP levels compared to the less than 1 mg/L CRP level were: hazards ratios, 2.50 and 2.66, respectively. The higher CRP levels also were associated with extended hospital stays (hazards ratios, 1.32 and 1.27, respectively).

"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, non-emergent 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," the authors write.

The study was funded in part by Biosite Inc., which manufactures and markets diagnostic products.

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