C-Reactive Protein as a Predictor of Difficult Laparoscopic Cholecystectomy in Patients with Acute Calculous Cholecystitis: A Multivariate Analysis

2017 ◽  
Vol 27 (12) ◽  
pp. 1263-1268 ◽  
Author(s):  
Aarón Díaz-Flores ◽  
Eduardo Cárdenas-Lailson ◽  
Adolfo Cuendis-Velázquez ◽  
Andrés Rodríguez-Parra ◽  
Mario E. Trejo-Ávila
Keyword(s):  
Multivariate Analysis ◽  
Laparoscopic Cholecystectomy ◽  
C Reactive Protein ◽  
Acute Calculous Cholecystitis ◽  
Reactive Protein ◽  
Calculous Cholecystitis

scholarly journals Prognostic Value of C-Reactive Protein, Glasgow Prognostic Score, and C-Reactive Protein-to-Albumin Ratio in Colorectal Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Jiahui Zhou ◽  
Wene Wei ◽  
Hu Hou ◽  
Shufang Ning ◽  
Jilin Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Roc Curve ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Stage I ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein

Background: Emerging evidence suggests that inflammatory response biomarkers are predictive factors that can improve the accuracy of colorectal cancer (CRC) prognoses. We aimed to evaluate the prognostic significance of C-reactive protein (CRP), the Glasgow Prognostic Score (GPS), and the CRP-to-albumin ratio (CAR) in CRC.Methods: Overall, 307 stage I–III CRC patients and 72 colorectal liver metastases (CRLM) patients were enrolled between October 2013 and September 2019. We investigated the correlation between the pretreatment CRP, GPS, and CAR and the clinicopathological characteristics. The Cox proportional hazards model was used for univariate or multivariate analysis to assess potential prognostic factors. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value of each prognostic score. We established CRC survival nomograms based on the prognostic scores of inflammation.Results: The optimal cutoff levels for the CAR for overall survival (OS) in all CRC patients, stage I–III CRC patients, and CRLM patients were 0.16, 0.14, and 0.25, respectively. Kaplan–Meier analysis and log-rank tests demonstrated that patients with high CRP, CAR, and GPS had poorer OS in CRC, both in the cohorts of stage I–III patients and CRLM patients. In the different cohorts of CRC patients, the area under the ROC curve (AUC) of these three markers were all high. Multivariate analysis indicated that the location of the primary tumor, pathological differentiation, and pretreatment carcinoembryonic antigen (CEA), CRP, GPS, and CAR were independent prognostic factors for OS in stage I–III patients and that CRP, GPS, and CAR were independent prognostic factors for OS in CRLM patients. The predictors in the prediction nomograms included the pretreatment CRP, GPS, and CAR.Conclusions: CRP, GPS, and CAR have independent prognostic values in patients with CRC. Furthermore, the survival nomograms based on CRP, GPS, and CAR can provide more valuable clinical significance.

scholarly journals The Prognostic Value of A Preoperative Lymphocyte Count and C-Reactive Protein Ratio In Osteosarcoma

2021 ◽  
Author(s):  
Shu-Yu Ji ◽  
Hai-Jun Tang ◽  
Xiao-Ting Luo ◽  
Wei-Feng Liang ◽  
Xian-Ying Huang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lymphocyte Count ◽  
Tumor Metastasis ◽  
Univariate Analysis ◽  
White Blood Cells ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Reactive Protein ◽  
Cutoff Values ◽  
Enneking Stage

Abstract Background: Systemic inflammatory response and nutritional status are closely related to tumor development, and both have been recognized as predictors of tumors. Our study investigated the effect on the prognosis of osteosarcoma by analyzing the ratio of lymphocytes to C-reactive protein (LCR) before surgery.Methods: Patients who were diagnosed with osteosarcoma and underwent surgery in the First Affiliated Hospital of Guangxi Medical University from 2012 to 2019 were included in this retrospective study. The albumin (g/L) +5 × total lymphocyte count (PNI), neutrophil/lymphocyte count (NLR), platelet/lymphocyte count (PLR) and platelet × neutrophil/lymphocyte count (SII) were calculated from preoperative peripheral white blood cells, C-reactive protein and serum albumin. The optimal cutoff values of LCR, PNI, NLR, PLR and SII were determined by receiver operating characteristic (ROC) analysis. According to the Optimal cutoff values, LCR, PNI, NLR, PLR and SII were divided into high and low groups. The Kaplan-Meier method was used to compare the overall survival (OS) between the high and low LCR groups. Univariate analysis was used to determine the influence of age, gender, tumor size, Enneking stage and neoadjuvant chemotherapy on the prognosis of osteosarcoma.The independent predictors of OS were determined by Cox multivariate analysis.Results: The optimal cutoff values for LCR, PNI, NLR, PLR and SII were 0.093, 48.4, 1.23, 157.03 and 314.27, respectively. A low preoperative LCR was significantly correlated with tumor metastasis, stage, NLR, PLR and SII. However, a low preoperative PNI was significantly associated with tumor metastasis, stage, and PLR.Kaplan-Meier survival analysis indicated that the postoperative OS was significantly correlated with preoperative LCR and PNI (P < 0.05). Univariate analysis showed that Enneking stage, metastasis and preoperative LCR, PNI, NLR, PLR and SII were important factors affecting OS (P < 0.05). For multivariate analysis, the results revealed that the preoperative LCR (HR, 0.401; 95% CI, 0.199-0.807; P = 0.01) and Enneking stage (HR, 2.717; 95%CI, 1.067-6.919; P = 0.036) is an independent prognostic factor affecting the postoperative OS of osteosarcoma.Conclusions: The high preoperative LCR is strongly associated with longer survival time in patients with osteosarcoma. Enneking stage and preoperative LCR may be important parameters for the prognosis of osteosarcoma.

5947Predictive role of C-reactive protein levels in patients with ST-segment elevation acute myocardial infarction for heart failure related events

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Van Tassell ◽  
C R Trankle ◽  
D Kadariya ◽  
J M Canada ◽  
S Carbone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Multivariate Analysis ◽  
Inflammatory Response ◽  
Composite Endpoint ◽  
The United States ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
St Segment

Abstract Background ST-segment elevation myocardial infarction (STEMI) is associated with an intense acute inflammatory response and an increased risk of death and heart failure (HF). C-reactive protein (CRP) is the inflammatory biomarker most commonly used for risk stratification in patients with cardiovascular diseases. CRP levels are known to rise and fall during STEMI in response to myocardial injury. In this study, we analyzed whether admission CRP or delayed CRP (measured at 72 hours after admission) held a greater predictive value for adverse HF events in patients with STEMI. Methods We analyzed data from the VCUART3 clinical trial enrolling 99 patients with STEMI within 12 hours of presentation at 3 sites in the United States of America treated with anakinra or placebo. CRP levels were measured with a high-sensitivity assay at time of admission and again at 72 hours later. A dedicated committee composed of individuals not involved in the conduct of the trial adjudicated HF events including a composite endpoint of death from any reason or incidence of HF defined as new-onset HF requiring hospital admission or a new prescription for a loop diuretic (D+HF) and a composite endpoint of death and HF hospitalization (D+HHF) at 1 year. We used a time-dependent Cox-regression analysis to determine the association of CRP at admission or at 72 hours with the outcomes of interest in univariate and multivariate analysis. Data are presented as median and interquartile range. (ClinicalTrials NCT01950299) Results CRP levels from admission and 72 hours were available in 90 and 87 subjects respectively and they increased from 4.6 [2.8–8.5] mg/L to 11.6 [4.6–24.5] mg/L (P<0.001). Both admission CRP (CRP0) and CRP at 72 hours (CRP72) were associated with the risk of D+HF (P=0.011 and <0.001, respectively) and of D+HHF (P=0.010 and P<0.001, respectively); however at multivariate analysis, only CRP72 remained significantly associated with the risk of D+HF (P=0.001) and D+HHF (P=0.004) while CRP0 was not. CRP72 significantly correlated with NTproBNP levels at 72 hours (NTproBNP72, Spearman rho R=+0.37, P=0.001). NTproBNP72 predicted D+HF (P=0.030) but not independently of CRP72 (P=0.096 for NTproBNP72 and P=0.007 for CRP72 at multivariate analysis including the 2 variables). NTproBNP72 did not predict D-HHF. Conclusions Among contemporary patients with STEMI, the levels of CRP at 72 hours after admission was superior to admission CRP levels for predicting the incidence of HF events, and independent of NTproBNP levels. Our results indicate the importance of the inflammatory response during STEMI, supporting the concept of inhibiting the inflammatory response as a therapeutic strategy. Acknowledgement/Funding Funded by NHLBI 1R34HL121402; Drug supply from Swedish Orphan Biovitrum

scholarly journals Nondrainage after Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis Does Not Increase the Postoperative Morbidity

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jianguo Qiu ◽  
Ming Li
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Postoperative Recovery ◽  
End Points ◽  
Acute Calculous Cholecystitis ◽  
Vas Score ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Significant Difference ◽  
Calculous Cholecystitis

Background. It is now established that prophylactic drainage is not needed after laparoscopic cholecystectomy (LC) for chronic calculous cholecystitis. However, the benefit of drains versus their potential harm for acute calculous cholecystitis (ACC) following laparoscopic LC has been questioned. Therefore, we conducted a comparative study to assess the need for drainage.Methods. Between January 2014 and October 2016, 212 patients with ACC undergoing LC undergo either drainage (n= 106) or no drainage (n= 106). The primary end points were the number of patients with postoperative drain-related complications, early and late Visual Analogue Scale (VAS) score, and hospital stay. Secondary end points included estimated blood loss, postoperative recovery, analgesia requirement, and cosmetic satisfaction result.Results. There was no bile duct injury and mortality in both groups. The overall complication rate was 12.5% with no significant difference between those with or without drainage (P=0.16). Normal activity resumption was significantly faster and the postoperative hospital stay was slightly shorter in the nondrainage group (P=0.03 andP= 0.04, respectively). The early VAS score in the drainage group was significantly higher (p<0.05). There were no significant differences between the two groups in postoperative hematology test, late VAS score, and patient satisfaction of cosmetic outcome.Conclusion. Routine drainage for patients with ACC after LC may not be justified with similar drain-related complications compared with nondrainage group.

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