Measurement of serum albumin and C-reactive protein (CRP) in patients preoperatively can identify those more likely to suffer major postoperative complications. The study was performed at Malmo University Hospital in Sweden.
Patients studied: 260 patients undergoing routine elective surgery over an 11 month period
Parameter
Value
Risk
serum albumin in g/dL
< 3.7
high
>= 3.7
low
C-reactive protein in mg/dL
> 1.0
high
<= 1.0
low
Performance of a low serum albumin to identify patients for major postoperative complications:
• sensitivity: 75%
• specificity: 56%
• positive predictive value: 22%
• negative predictive value: 93%
Performance of a elevated C-reactive protein to identify patients for major postoperative complications:
• sensitivity: 52%
• specificity: 75%
• positive predictive value: 25%
• negative predictive value: 91%
Using both parameters (low serum albumin and high CRP) increased the sensitivity and specificity. This was particularly true in patients with cancer.
Limitations:
• Sensitivities and specificities are not that spectacular.
• The negative predictive value may of some utility.
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