J Curr Surg

Journal of Current Surgery, ISSN 1927-1298 print, 1927-1301 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Curr Surg and Elmer Press Inc

Journal website http://www.currentsurgery.org

Original Article

Volume 4, Number 3, September 2014, pages 61-69

The Effect of Gender, Age and BMI on Postoperative C-Reactive Protein Levels After Major Abdominal Surgery

Figure 1. Average CRP levels in male and female patients with a minor or uncomplicated postoperative course and male and female patients with major complications.

Figure 2. Average CRP levels in patients younger or older than 65 years with a minor or uncomplicated postoperative course and patients younger or older than 65 years with major complications.

Figure 3. Average CRP levels in patients with a BMI above or below 25 kg/m² with a minor or uncomplicated postoperative course and patients with a BMI above or below 25 kg/m² with major complications.

**Table 1.** Baseline Characteristics
Parameter	Upper GI	HPB	Lower GI	Total	P-value
Patients (n)	74 (18.5%)	91 (22.8%)	234 (58.6%)	399
Gender
Male	50 (67.6%)	54 (59.3%)	131 (56.0%)	235 (58.9%)
Female	24 (32.4%)	37 (40.7%)	103 (44.0%)	164 (41.1%)	0.209
Age, years (mean ± SD)	63.2 ± 13.4	59.2 ± 11.6	59.6 ± 17.3	60.2 ± 15.5	0.168
ASA score (mean ± SD)	1.2 ± 0.7	1.1 ± 0.5	1.1 ± 0.7	1.1 ± 0.7	0.291
BMI mean ± SD	23.9 ± 3.8	25.1 ± 4.2	25.6 ± 6.1	25.1 ± 5.3	0.066
Indication
Elective	65 (87.8%)	87 (95.6%)	176 (75.2%)	328 (82.2%)
Acute	9 (12.1%)	4 (4.4%)	58 (24.8%)	71 (17.8%)	0.001
Malignant	61 (82.4%)	76 (83.5%)	137 (58.5%)	274 (68.7%)
Benign	13 (17.6%)	15 (16.5%)	97 (41.5%)	125 (31.3%)	< 0.001
Epidural anesthesia	42 (58.3%)	62 (68.9%)	127 (55.9%)	231 (57.9%)	0.105
Operation access
Laparotomy	49 (66.2%)	78 (85.7%)	121 (51.7%)	248 (62.2%)
Laparoscopy	20 (27%)	13 (14.3%)	96 (41%)	129 (32.3%)
Conversion	5 (6.8%)	0	17 (7.3%)	22 (5.5%)	< 0.001
Anastomosis	64 (86.5%)	24 (26.4%)	168 (71.8%)	256 (64.2%)	< 0.001
Ostomy	0	0	80 (38.6%)		< 0.001
Protective ostomy	0	0	27 (11.5%)		< 0.001
Drain (mL ± SD)	56 (78.9%)	39 (43.8%)	91 (39.7%)	186 (46.6%)	0.001
Duration of surgery (min ± SD)	275.8 ± 105.4	249.5 ± 214.5	188.1 ± 75.6	217.6 ± 132.7	< 0.001
Perioperative blood loss (mL ± SD)	451.7 ± 774.8	347.4 ± 521.8	229.1 ± 478.1	295.7 ± 554	0.016
Complication	39 (52.7%)	22 (24.2%)	82 (35%)	143 (35.8%)	0.002
Major complication	26 (35.1%)	12 (13.2%)	45 (19.2%)	83 (20.8%)	0.002
Minor complication	13 (17.6%)	10 (11%)	36 (15.4%)	59 (14%)
Hospital stay (days ± SD)	24.7 ± 22.3	11.4 ± 17.2	15.3 ± 20.7	16.1 ± 20.7	< 0.001
Intensive care stay (days ± SD)	13.1 ± 20.7	6.8 ± 16.9	11.5 ± 17.4	11.3 ± 18.8	0.496
Mortality	6 (8.1%)	2 (2.2%)	6 (2.6%)	14 (3.5%)	0.058

Table 1. Baseline Characteristics

Parameter

Upper GI

HPB

Lower GI

Total

P-value

Patients (n)

74 (18.5%)

91 (22.8%)

234 (58.6%)

399

Gender

Male

50 (67.6%)

54 (59.3%)

131 (56.0%)

235 (58.9%)

Female

24 (32.4%)

37 (40.7%)

103 (44.0%)

164 (41.1%)

0.209

Age, years (mean ± SD)

63.2 ± 13.4

59.2 ± 11.6

59.6 ± 17.3

60.2 ± 15.5

0.168

ASA score (mean ± SD)

1.2 ± 0.7

1.1 ± 0.5

1.1 ± 0.7

0.291

BMI mean ± SD

23.9 ± 3.8

25.1 ± 4.2

25.6 ± 6.1

25.1 ± 5.3

0.066

Indication

Elective

65 (87.8%)

87 (95.6%)

176 (75.2%)

328 (82.2%)

Acute

9 (12.1%)

4 (4.4%)

58 (24.8%)

71 (17.8%)

0.001

Malignant

61 (82.4%)

76 (83.5%)

137 (58.5%)

274 (68.7%)

Benign

13 (17.6%)

15 (16.5%)

97 (41.5%)

125 (31.3%)

< 0.001

Epidural anesthesia

42 (58.3%)

62 (68.9%)

127 (55.9%)

231 (57.9%)

0.105

Operation access

Laparotomy

49 (66.2%)

78 (85.7%)

121 (51.7%)

248 (62.2%)

Laparoscopy

20 (27%)

13 (14.3%)

96 (41%)

129 (32.3%)

Conversion

5 (6.8%)

17 (7.3%)

22 (5.5%)

< 0.001

Anastomosis

64 (86.5%)

24 (26.4%)

168 (71.8%)

256 (64.2%)

< 0.001

Ostomy

80 (38.6%)

< 0.001

Protective ostomy

27 (11.5%)

< 0.001

Drain (mL ± SD)

56 (78.9%)

39 (43.8%)

91 (39.7%)

186 (46.6%)

0.001

Duration of surgery (min ± SD)

275.8 ± 105.4

249.5 ± 214.5

188.1 ± 75.6

217.6 ± 132.7

< 0.001

Perioperative blood loss (mL ± SD)

451.7 ± 774.8

347.4 ± 521.8

229.1 ± 478.1

295.7 ± 554

0.016

Complication

39 (52.7%)

22 (24.2%)

82 (35%)

143 (35.8%)

0.002

Major complication

26 (35.1%)

12 (13.2%)

45 (19.2%)

83 (20.8%)

0.002

Minor complication

13 (17.6%)

10 (11%)

36 (15.4%)

59 (14%)

Hospital stay (days ± SD)

24.7 ± 22.3

11.4 ± 17.2

15.3 ± 20.7

16.1 ± 20.7

< 0.001

Intensive care stay (days ± SD)

13.1 ± 20.7

6.8 ± 16.9

11.5 ± 17.4

11.3 ± 18.8

0.496

Mortality

6 (8.1%)

2 (2.2%)

6 (2.6%)

14 (3.5%)

0.058

**Table 2.** Correlation Between CRP Levels and Age in the Overall Group and Within the Group of Patients With Major Complications, Correlation Coefficients and P-Values Depicted
POD	Overall	Major complications
0	61.27 ± 119	-0.109	0.334	69.13 ± 113	-0.198	0.353
1	112.2 ± 67.3	0.099	0.117	127.6 ± 84.4	0.388	0.543
2	219.8 ± 109.1	-0.092	0.225	281.5 ± 94.5	-0.197	0.229
3	192.3 ± 101.6	0.029	0.674	261.1 ± 117.5	-0.021	0.889
4	154.7 ± 89.5	-0.092	0.189	207.92 ± 110.8	-0.104	0.467
5	137.6 ± 93.4	-0.061	0.433	177.2 ± 103.9	-0.075	0.602
6	138.8 ± 101.6	-0.021	0.803	194.1 ± 97.9	0.031	0.84

Table 2. Correlation Between CRP Levels and Age in the Overall Group and Within the Group of Patients With Major Complications, Correlation Coefficients and P-Values Depicted

POD

Overall

Major complications

Mean CRP (mg/L) ± SD

Correlation

P-value

Mean CRP (mg/L) ± SD

Correlation

P-value

61.27 ± 119

-0.109

0.334

69.13 ± 113

-0.198

0.353

112.2 ± 67.3

0.099

0.117

127.6 ± 84.4

0.388

0.543

219.8 ± 109.1

-0.092

0.225

281.5 ± 94.5

-0.197

0.229

192.3 ± 101.6

0.029

0.674

261.1 ± 117.5

-0.021

0.889

154.7 ± 89.5

-0.092

0.189

207.92 ± 110.8

-0.104

0.467

137.6 ± 93.4

-0.061

0.433

177.2 ± 103.9

-0.075

0.602

138.8 ± 101.6

-0.021

0.803

194.1 ± 97.9

0.031

0.84

**Table 3.** Correlation Between CRP Levels and BMI in the Overall Group and Within the Group of Patients With Major Complications, Correlation Coefficients and P-Values Depicted
POD	Overall	Major complications
0	61.27 ± 119	0.28	0.015	69.13 ± 113	0.226	0.312
1	112.2 ± 67.3	0.197	0.002	127.6 ± 84.4	0.251	0.07
2	219.8 ± 109.1	0.158	0.04	281.5 ± 94.5	0.293	0.07
3	192.3 ± 101.6	0.139	0.048	261.1 ± 117.5	0.172	0.248
4	154.7 ± 89.5	0.231	0.001	207.92 ± 110.8	0.314	0.028
5	137.6 ± 93.4	0.082	0.304	177.2 ± 103.9	0.146	0.311
6	138.8 ± 101.6	0.095	0.262	194.1 ± 97.9	0.051	0.744

Table 3. Correlation Between CRP Levels and BMI in the Overall Group and Within the Group of Patients With Major Complications, Correlation Coefficients and P-Values Depicted

POD

Overall

Major complications

Mean CRP (mg/L) ± SD

Correlation

P-value

Mean CRP (mg/L) ± SD

Correlation

P-value

61.27 ± 119

0.28

0.015

69.13 ± 113

0.226

0.312

112.2 ± 67.3

0.197

0.002

127.6 ± 84.4

0.251

0.07

219.8 ± 109.1

0.158

0.04

281.5 ± 94.5

0.293

0.07

192.3 ± 101.6

0.139

0.048

261.1 ± 117.5

0.172

0.248

154.7 ± 89.5

0.231

0.001

207.92 ± 110.8

0.314

0.028

137.6 ± 93.4

0.082

0.304

177.2 ± 103.9

0.146

0.311

138.8 ± 101.6

0.095

0.262

194.1 ± 97.9

0.051

0.744

**Table 4.** Linear Regression Coefficients for BMI and CRP Levels on Postoperative Days 3, 4 and 5
POD	B	Sig	Beta	R-square
3	2.982	0.03	0.153	0.023
4	2.687	0.023	0.164	0.027
5	1.012	0.502	0.053	0.003

Table 4. Linear Regression Coefficients for BMI and CRP Levels on Postoperative Days 3, 4 and 5

POD

Sig

Beta

R-square

2.982

0.03

0.153

0.023

2.687

0.023

0.164

0.027

1.012

0.502

0.053

0.003