Preoperative c-reactive protein predicts long-term mortality and hospital length of stay after primary, nonemergent coronary artery bypass grafting

Tjörvi E. Perry, Jochen D. Muehlschlegel, Kuang Yu Liu, Amanda A. Fox, Charles D. Collard, Simon C. Body, Stanton K. Shernan

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)607-613
Number of pages7
JournalAnesthesiology
Volume112
Issue number3
DOIs
StatePublished - Mar 2010

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Coronary Artery Bypass
Length of Stay
C-Reactive Protein
Mortality
Proteins
Transplants
Patient Acuity
Proportional Hazards Models
Thoracic Surgery
Morbidity

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Preoperative c-reactive protein predicts long-term mortality and hospital length of stay after primary, nonemergent coronary artery bypass grafting. / Perry, Tjörvi E.; Muehlschlegel, Jochen D.; Liu, Kuang Yu; Fox, Amanda A.; Collard, Charles D.; Body, Simon C.; Shernan, Stanton K.

In: Anesthesiology, Vol. 112, No. 3, 03.2010, p. 607-613.

Research output: Contribution to journalArticle

Perry, Tjörvi E. ; Muehlschlegel, Jochen D. ; Liu, Kuang Yu ; Fox, Amanda A. ; Collard, Charles D. ; Body, Simon C. ; Shernan, Stanton K. / Preoperative c-reactive protein predicts long-term mortality and hospital length of stay after primary, nonemergent coronary artery bypass grafting. In: Anesthesiology. 2010 ; Vol. 112, No. 3. pp. 607-613.
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abstract = "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.",
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T1 - Preoperative c-reactive protein predicts long-term mortality and hospital length of stay after primary, nonemergent coronary artery bypass grafting

AU - Perry, Tjörvi E.

AU - Muehlschlegel, Jochen D.

AU - Liu, Kuang Yu

AU - Fox, Amanda A.

AU - Collard, Charles D.

AU - Body, Simon C.

AU - Shernan, Stanton K.

PY - 2010/3

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N2 - 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.

AB - 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.

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