Increased preoperative c-reactive protein level as a prognostic factor for postoperative amputation after femoropopliteal bypass surgery for CLI

Ann Chir Gynaecol. 2001;90(1):19-22.

Abstract

Background and aims: We evaluated the possible predictive role of C-reactive protein (CRP) on the immediate postoperative outcome after femoropopliteal bypass surgery for critical leg ischaemia (CLI).

Material and methods: 138 patients with CLI who underwent 143 femoropopliteal reconstructions.

Results: The immediate postoperative period secondary patency rate was 87%, leg salvage rate was 94%, and survival rate 97%. Nine patients (6.3%) had 30-day postoperative major amputation, three of them despite a patent bypass graft because of progression of foot infection. The preoperative serum concentration of CRP was the only predictor of postoperative major amputation (p = 0.004; for an increase of 10 mg/l: OR, 1.188; CI 95%, 1.059-1.332). The median preoperative serum concentration of CRP among patients who did not have major amputation was 13.0 mg/l (range, 1-185), whereas it was 47.5 mg/l (range, 5-168) among those who had amputation after bypass graft occlusion, and 115.0 mg/l (range, 34-222) among those who had amputation despite a patent bypass graft (p = 0.008).

Conclusions: CRP may be a useful marker in risk stratification for postoperative amputation in patients undergoing femoropopliteal bypass surgery for CLI.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • C-Reactive Protein / analysis*
  • Female
  • Femoral Artery / surgery*
  • Humans
  • Ischemia / surgery*
  • Leg / blood supply*
  • Leg / surgery*
  • Male
  • Middle Aged
  • Popliteal Artery / surgery*
  • Postoperative Care
  • Postoperative Complications / surgery*
  • Preoperative Care
  • Prognosis

Substances

  • C-Reactive Protein