PROGNOSTIC VALUE OF PREOPERATIVE C-REACTIVE PROTEIN-CONCENTRATION ANDWHITE CELL COUNT IN ACUTE EXTREMITY ISCHEMIA

Objective: To find out if the C-reactive protein (CRP) concentration a nd the white cell count (WCC) are of any prognostic value in patients with acute extremity ischaemia. Design: Retrospective study. Setting: Tampere University Hospital and Jyvaskyla Central Hospital, Finland. S ubjects: 129 patients with acute extremity ischaemia. Main outcome mea sures: Preoperative CRP concentration, white cell count, packed cell v olume, serum creatinine concentration, major amputation and death. Res ults: The median (range) CRP concentration was 50.0 (3-271) mg/l in th e 28 patients who underwent major amputation or died (group 1) and 11. 0 (1-175) mg/l in the 65 patients who survived with viable limbs (grou p 2) (p = 0.007). The median (range) WCC was 13.1 (5.9-42.0) x 10(9)/l in group 1 (30 patients) and 9.5 (2.2-23.9) x 10(9)/l in group 2 (79 patients) (p < 0.001). The cut-off point of 20 mg/l for CRP and 11.0 x 10(9)/l for WCC had negative predictive values of 0.83 and 0.85 for a mputation and mortality, respectively. Conclusion: Preoperative CRP co ncentration and WCC correlated with limb salvage and mortality in pati ents with acute extremity ischaemia.