[article] 
inAnnals of physical and rehabilitation medicine > Vol. 51, n°5 (Juin 2008) . - pp.348-357

Titre :	The value of C-reactive protein for postoperative monitoring of lower limb arthroplasty
Titre original :	Évaluation de l'intérêt de la CRP dans la surveillance postopératoire des arthroplasties prothétiques de membre inférieur
Type de document :	texte imprimé
Année de publication :	2008
Article en page(s) :	pp.348-357
Langues :	Français (fre)
Résumé :	Objectives. - Determination of the utility of C-reactive protein (CRP) levels when measured 21 days after hip and knee arthroplasties for early diagnosis of infectious complications. Method. - This study was performed in two parts: establishment of a reference curve by measurement of CRP levels once a week in a cohort of 94 patients (50 total hip arthroplasties and 44 total or unicondylar knee arthroplasties); study of the diagnostic value of two different CRP cut-offs (25 mg/l, the mean CRP level and two standard deviations; 18 mg/l, mean and one standard deviation) at D21 postoperative in a population of 48 patients, of whom 12 presented septic complications (four surgical site infections [SSIs] and eight intercurrent infections). Results. - We observed very high interindividual variations in CRP values two weeks after arthroplasty. These variations decreased strongly in the third week postoperative. In the seven patients with a CRP level above 25 mg/l at D21, there were no false-positives. In the 41 patients with a CRP level below 25 mg/l at D21, there were five false-negatives and no false-positives. With the CRP threshold set at 18 mg/l, we observed four false-positives and four false-negatives. Discussion-conclusion. - A CRP level threshold of 25 mg/l is not sufficiently reliable for early detection of postoperative infections (whether at the surgical site or elsewhere), as judged by a sensitivity of 58.3% and a negative predictive value of 87.8%. However, the 25 mg/l t
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[article] The value of C-reactive protein for postoperative monitoring of lower limb arthroplasty = Évaluation de l'intérêt de la CRP dans la surveillance postopératoire des arthroplasties prothétiques de membre inférieur [texte imprimé] . - 2008 . - pp.348-357.
Langues : Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 51, n°5 (Juin 2008) . - pp.348-357

Résumé :

Objectives. - Determination of the utility of C-reactive protein (CRP) levels when measured 21 days after hip and knee arthroplasties for early diagnosis of infectious complications. Method. - This study was performed in two parts: establishment of a reference curve by measurement of CRP levels once a week in a cohort of 94 patients (50 total hip arthroplasties and 44 total or unicondylar knee arthroplasties); study of the diagnostic value of two different CRP cut-offs (25 mg/l, the mean CRP level and two standard deviations; 18 mg/l, mean and one standard deviation) at D21 postoperative in a population of 48 patients, of whom 12 presented septic complications (four surgical site infections [SSIs] and eight intercurrent infections). Results. - We observed very high interindividual variations in CRP values two weeks after arthroplasty. These variations decreased strongly in the third week postoperative. In the seven patients with a CRP level above 25 mg/l at D21, there were no false-positives. In the 41 patients with a CRP level below 25 mg/l at D21, there were five false-negatives and no false-positives. With the CRP threshold set at 18 mg/l, we observed four false-positives and four false-negatives. Discussion-conclusion. - A CRP level threshold of 25 mg/l is not sufficiently reliable for early detection of postoperative infections (whether at the surgical site or elsewhere), as judged by a sensitivity of 58.3% and a negative predictive value of 87.8%. However, the 25 mg/l t

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