Increased preoperative C-reactive protein level as a prognostic factor forpostoperative amputation after femoropopliteal bypass surgery for CLI

Background and Aims: We evaluated the possible predictive role of C-reactiv e protein (CRP) on the immediate postoperative outcome after femoropoplitea l bypass surgery for critical leg ischaemia (CLI). Material and Methods: 138 patients with CLI who underwent 143 femoropoplite al reconstructions. Results: The immediate postoperative period secondary patency rate was 87 % , leg salvage rate was 94 %, and survival rate 97 %. Nine patients (6.3 %) had 30-day postoperative major amputation, three of them despite a patent b ypass graft because of progression of foot infection. The preoperative seru m concentration of CRP was the only predictor of postoperative major amputa tion (p = 0.004; for an increase of 10 mg/l: OR, 1.188; CI 95 %, 1.059-1.33 2). The median preoperative serum concentration of CRP among patients who d id not have major amputation was 13.0 mg/l (range, 1-185), whereas it was 4 7.5 mg/l (range, 5-168) among those who had amputation after bypass graft o cclusion, and 115.0 mg/l (range, 34-222) among those who had amputation des pite a patent bypass graft (p = 0.008). Conclusions: CRP may be a useful marker in risk stratification for postoper ative amputation in patients undergoing femoropopliteal bypass surgery for CLI.