CRP Monitoring in Fractured Neck of Femur. A Waste of Resource?

Publication date: Available online 11 July 2018

Source: Injury

Author(s): Mobeen Qureshi, Ignatius Liew, Oliver Bailey

Abstract

Aim

We aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively.

Study Design and Methods

Retrospective analysis was carried out on all NOF#'s admitted for surgical fixation between August 2015 and July 2016 in a district general hospital. Primary analysis included serum CRP levels until day 7 post-operatively, with secondary analysis of any documented evidence of post-operative complications (medical and surgical) within 30 days post-operatively.

Results

A total of 365 patients were surgically treated for NOF#'s over the study period. CRP serum levels peaked over the first two days post-operatively to median (IQ range) of 226 mg/L (158 – 299 mg/L), decreasing to 67 mg/L (45.5 – 104 mg/L) by day 7 post-operatively. 116 patients had documented post-operative complications within 30 daysof operation. CRP levels in patients with and without complications showed no statistical significance in day-1, day-2 and day-3 post-operatively. However, a significant difference was demonstrated on day-4 (p = 0.017), day-5 (p = 0.003), day-6 (p = 0.02) and day-7 (p = 0.031)

Conclusions

During the first three days of the postoperative period we cannot recommend routine CRP serum blood test monitoring in NOF# patients, as it is not diagnostic in the acute inflammatory phase for medical or surgical complications.

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