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D.G. Augusto



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    P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P2.02-009 - Expected Variability of C-Reactive Protein after Pulmonary Resections: Which Factors Are Associated with Their Normal Variation? (ID 2513)

      09:30 - 09:30  |  Author(s): D.G. Augusto

      • Abstract
      • Slides

      Background:
      In patients undergoing lung resection, infectious complications are diagnosed when clinical and radiological evidences are observed. Therefore, early detection of complications may benefit patients and could lead cost reduction. C-reactive protein (CRP) measurements persistently high may indicate complications after surgical resection. Our aim is to define the expected variability of CRP after pulmonary resections which have not progressed to clinical or surgical complications.

      Methods:
      Retrospective Cohort of patients with neoplastic lung disease treated by anatomic pulmonary resection, between January-2010 and June-2014, which had not developed postoperative complications. A CRP curve was built with data until the fifth postoperative day (POD). Surgical and clinical data was collected to look for predictors of CRP values. Statistical analysis was made with median and confidence interval, T-test for median comparison and logistic regression for predictors.

      Results:
      We analyzed 220 medical records, 100 patients were excluded because lack of data and 50 due to complication development. Seventy patients were included. The median age was 65 years (from 14 to 89). Forty-one were male (58%). Ten patients (14,8%) had Diabetes, 1 (1,42%) hepatopathy and 1 (1,42%) renal failure. Sixty-one patients (87,14%) underwent lobectomy, 8 (11,42%) pneumonectomy and 1 (1,42%) segmentectomy. There were 48 (68,57%) open thoracotomy and 22 (31,42%) video assisted thoracotomy. The histologic type of tumor was 33 (47,14%) adenocarcinoma, 14 (20%) spinocellular carcinoma, 3 (4,28%) benign diseases and 20 (28,57%) others. The median CRP were 12,85 mg/dl (CI-5,44) preoperative; 76,82 mg/dl (CI-8,49) first day, 156,36 mg/dl (CI-17,91) second , 132,35 mg/dl (CI-17,62) third, 103,24 mg/dl (CI-16,29) forth and 94,11 mg/dl (CI-14,32) fifth. Logistic regression pointed that patients operated by videothoracoscopy (VATS) approach are associated with are associated with lower increase of CRP levels (p=0,002). Other studied factors as age, sex, type of surgery, comorbidities and histology fail to predict CRP level.

      Conclusion:
      It was observed that CRP peak occurs in the second POD. From the third to the fifth POD, there was a drop of CRP levels, however, it does not returne to the preoperative baseline. The VATS approach induces smaller increases in CRP

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