Prediction of early C-reactive protein levels after non-cardiac surgery under general anesthesia
Early detection of postoperative increase in C-reactive protein (CRP) correlates with postoperative complications. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early pos...
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| description | Early detection of postoperative increase in C-reactive protein (CRP) correlates with postoperative complications. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early postoperative CRP level, for prophylactic management of postoperative complications in patients undergoing surgery under general anesthesia.
Multivariate regression analysis was retrospectively performed to determine the independent factor of CRP levels on postoperative day (POD) 1 and to develop a prediction model. Validation of the prediction model was prospectively performed. Data from 316 adult patients on perioperative variables were retrospectively obtained in a training cohort in patients undergoing elective non-cardiac surgery. In a validation cohort, 88 patients undergoing mastectomy and 68 patients undergoing laparoscopic colon surgery were prospectively utilized to evaluate the value of the prediction model. Major complications after surgery were defined as the Clavien-Dindo grade IIIa or greater.
Duration of surgery, mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative CRP level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001). In the validation cohort, the predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001). Receiver-operating characteristic curve analysis showed that the predicted CRP levels on POD1 was significantly associated with major complications after mastectomy (P = 0.0259) and laparoscopic colon surgery (P = 0.0049). The measured and predicted CRP levels significantly increased in the order of severity of postoperative complications (P < 0.01).
Increases in duration of surgery, intraoperative nociceptive level and preoperative CRP level were selected to predict early increases in CRP level after non-cardiac surgery under general anesthesia. Predicted CRP levels on POD1 were likely associated with severity of postoperative complications. |
| doi_str_mv | 10.1371/journal.pone.0226032 |
| format | Article |
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Multivariate regression analysis was retrospectively performed to determine the independent factor of CRP levels on postoperative day (POD) 1 and to develop a prediction model. Validation of the prediction model was prospectively performed. Data from 316 adult patients on perioperative variables were retrospectively obtained in a training cohort in patients undergoing elective non-cardiac surgery. In a validation cohort, 88 patients undergoing mastectomy and 68 patients undergoing laparoscopic colon surgery were prospectively utilized to evaluate the value of the prediction model. Major complications after surgery were defined as the Clavien-Dindo grade IIIa or greater.
Duration of surgery, mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative CRP level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001). In the validation cohort, the predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001). Receiver-operating characteristic curve analysis showed that the predicted CRP levels on POD1 was significantly associated with major complications after mastectomy (P = 0.0259) and laparoscopic colon surgery (P = 0.0049). The measured and predicted CRP levels significantly increased in the order of severity of postoperative complications (P < 0.01).
Increases in duration of surgery, intraoperative nociceptive level and preoperative CRP level were selected to predict early increases in CRP level after non-cardiac surgery under general anesthesia. Predicted CRP levels on POD1 were likely associated with severity of postoperative complications.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0226032</identifier><identifier>PMID: 31790508</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abdomen ; Abdominal surgery ; Aged ; Analysis ; Anesthesia ; Anesthesia, General ; Anesthesiology ; Area Under Curve ; Biology and Life Sciences ; Blood pressure ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; C-reactive protein ; C-Reactive Protein - metabolism ; Colon ; Colonic Diseases - pathology ; Colonic Diseases - surgery ; Complications ; Correlation analysis ; Female ; Heart ; Heart surgery ; Humans ; Joint surgery ; Laparoscopy ; Laparoscopy - adverse effects ; Levels ; Linear Models ; Male ; Mastectomy ; Mastectomy - adverse effects ; Medical personnel ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Ostomy ; Pain ; Pain perception ; Physical Sciences ; Postoperative complications ; Postoperative Complications - etiology ; Postoperative Period ; Prediction models ; Proteins ; Regression analysis ; Remifentanil ; Research and Analysis Methods ; Retrospective Studies ; ROC Curve ; Severity of Illness Index ; Stress response ; Surgery ; Thoracic surgery</subject><ispartof>PloS one, 2019-12, Vol.14 (12), p.e0226032-e0226032</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Nakamoto, Hirose. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Nakamoto, Hirose 2019 Nakamoto, Hirose</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-fdc24173c6c4e45d8fa803d4ef874f14bad5dfadc198bdf2aad2a7ed575379b63</citedby><cites>FETCH-LOGICAL-c758t-fdc24173c6c4e45d8fa803d4ef874f14bad5dfadc198bdf2aad2a7ed575379b63</cites><orcidid>0000-0003-1291-2827</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886833/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886833/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31790508$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Farag, Ehab</contributor><creatorcontrib>Nakamoto, Shiroh</creatorcontrib><creatorcontrib>Hirose, Munetaka</creatorcontrib><title>Prediction of early C-reactive protein levels after non-cardiac surgery under general anesthesia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Early detection of postoperative increase in C-reactive protein (CRP) correlates with postoperative complications. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early postoperative CRP level, for prophylactic management of postoperative complications in patients undergoing surgery under general anesthesia.
Multivariate regression analysis was retrospectively performed to determine the independent factor of CRP levels on postoperative day (POD) 1 and to develop a prediction model. Validation of the prediction model was prospectively performed. Data from 316 adult patients on perioperative variables were retrospectively obtained in a training cohort in patients undergoing elective non-cardiac surgery. In a validation cohort, 88 patients undergoing mastectomy and 68 patients undergoing laparoscopic colon surgery were prospectively utilized to evaluate the value of the prediction model. Major complications after surgery were defined as the Clavien-Dindo grade IIIa or greater.
Duration of surgery, mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative CRP level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001). In the validation cohort, the predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001). Receiver-operating characteristic curve analysis showed that the predicted CRP levels on POD1 was significantly associated with major complications after mastectomy (P = 0.0259) and laparoscopic colon surgery (P = 0.0049). The measured and predicted CRP levels significantly increased in the order of severity of postoperative complications (P < 0.01).
Increases in duration of surgery, intraoperative nociceptive level and preoperative CRP level were selected to predict early increases in CRP level after non-cardiac surgery under general anesthesia. Predicted CRP levels on POD1 were likely associated with severity of postoperative complications.</description><subject>Abdomen</subject><subject>Abdominal surgery</subject><subject>Aged</subject><subject>Analysis</subject><subject>Anesthesia</subject><subject>Anesthesia, General</subject><subject>Anesthesiology</subject><subject>Area Under Curve</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Colon</subject><subject>Colonic Diseases - pathology</subject><subject>Colonic Diseases - surgery</subject><subject>Complications</subject><subject>Correlation analysis</subject><subject>Female</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Levels</subject><subject>Linear Models</subject><subject>Male</subject><subject>Mastectomy</subject><subject>Mastectomy - adverse effects</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Pain perception</subject><subject>Physical Sciences</subject><subject>Postoperative complications</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Period</subject><subject>Prediction models</subject><subject>Proteins</subject><subject>Regression analysis</subject><subject>Remifentanil</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Stress response</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk02P0zAQhiMEYpfCP0AQCQnBIcWJk9i5IK0qPiqttIivq5nY49YrN-7aSUX_PS7Nrhq0B5SDo_Ezr_2OZ5LkeU7mOWX5u2s3-A7sfOs6nJOiqAktHiTneUOLrC4IfXjyf5Y8CeGakIryun6cnNGcNaQi_Dz59cWjMrI3rkudThG83aeLzCPE2A7TrXc9mi61uEMbUtA9-rRzXSbBKwMyDYNfod-nQ6fizgo79GBT6DD0awwGniaPNNiAz8Z1lvz4-OH74nN2efVpubi4zCSreJ9pJYsyZ1TWssSyUlwDJ1SVqDkrdV62oCqlQcm84a3SBYAqgKGqWEVZ09Z0lrw86m6tC2IsThAFLQinhEXrs2R5JJSDa7H1ZgN-LxwY8Tfg_EqA7420KBquc6YaUpYMS1kyXqtW85wDlznRLUSt9-NpQ7tBJbHro-2J6HSnM2uxcjtRc15zSqPAm1HAu5shFktsTJBobaycG8Z7R2_FAX31D3q_u5FaQTRgOu3iufIgKi5qwmjFGC8jNb-Hip_CjZGxk7SJ8UnC20lCZHr83a9gCEEsv339f_bq55R9fcKuEWy_Ds4Oh0YMU7A8gtK7EDzquyLnRBwG4bYa4jAIYhyEmPbi9IHukm47n_4B45sEsA</recordid><startdate>20191202</startdate><enddate>20191202</enddate><creator>Nakamoto, Shiroh</creator><creator>Hirose, Munetaka</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1291-2827</orcidid></search><sort><creationdate>20191202</creationdate><title>Prediction of early C-reactive protein levels after non-cardiac surgery under general anesthesia</title><author>Nakamoto, Shiroh ; Hirose, Munetaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-fdc24173c6c4e45d8fa803d4ef874f14bad5dfadc198bdf2aad2a7ed575379b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Abdominal surgery</topic><topic>Aged</topic><topic>Analysis</topic><topic>Anesthesia</topic><topic>Anesthesia, General</topic><topic>Anesthesiology</topic><topic>Area Under Curve</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - metabolism</topic><topic>Colon</topic><topic>Colonic Diseases - pathology</topic><topic>Colonic Diseases - surgery</topic><topic>Complications</topic><topic>Correlation analysis</topic><topic>Female</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Levels</topic><topic>Linear Models</topic><topic>Male</topic><topic>Mastectomy</topic><topic>Mastectomy - adverse effects</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Ostomy</topic><topic>Pain</topic><topic>Pain perception</topic><topic>Physical Sciences</topic><topic>Postoperative complications</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Period</topic><topic>Prediction models</topic><topic>Proteins</topic><topic>Regression analysis</topic><topic>Remifentanil</topic><topic>Research and Analysis Methods</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>Stress response</topic><topic>Surgery</topic><topic>Thoracic surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakamoto, Shiroh</creatorcontrib><creatorcontrib>Hirose, Munetaka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakamoto, Shiroh</au><au>Hirose, Munetaka</au><au>Farag, Ehab</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of early C-reactive protein levels after non-cardiac surgery under general anesthesia</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-12-02</date><risdate>2019</risdate><volume>14</volume><issue>12</issue><spage>e0226032</spage><epage>e0226032</epage><pages>e0226032-e0226032</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Early detection of postoperative increase in C-reactive protein (CRP) correlates with postoperative complications. The present study examined the association between preoperative / intraoperative factors and postoperative CRP levels, with development and validation of a prediction model of early postoperative CRP level, for prophylactic management of postoperative complications in patients undergoing surgery under general anesthesia.
Multivariate regression analysis was retrospectively performed to determine the independent factor of CRP levels on postoperative day (POD) 1 and to develop a prediction model. Validation of the prediction model was prospectively performed. Data from 316 adult patients on perioperative variables were retrospectively obtained in a training cohort in patients undergoing elective non-cardiac surgery. In a validation cohort, 88 patients undergoing mastectomy and 68 patients undergoing laparoscopic colon surgery were prospectively utilized to evaluate the value of the prediction model. Major complications after surgery were defined as the Clavien-Dindo grade IIIa or greater.
Duration of surgery, mean nociceptive response (NR) during surgery as intraoperative nociception level, and preoperative CRP level were selected to set up the prediction model of CRP level on POD1 (P < 0.0001). In the validation cohort, the predicted CRP levels on POD1 significantly correlated with the measured CRP after mastectomy (P < 0.0001) and laparoscopic colon surgery (P = 0.0001). Receiver-operating characteristic curve analysis showed that the predicted CRP levels on POD1 was significantly associated with major complications after mastectomy (P = 0.0259) and laparoscopic colon surgery (P = 0.0049). The measured and predicted CRP levels significantly increased in the order of severity of postoperative complications (P < 0.01).
Increases in duration of surgery, intraoperative nociceptive level and preoperative CRP level were selected to predict early increases in CRP level after non-cardiac surgery under general anesthesia. Predicted CRP levels on POD1 were likely associated with severity of postoperative complications.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31790508</pmid><doi>10.1371/journal.pone.0226032</doi><tpages>e0226032</tpages><orcidid>https://orcid.org/0000-0003-1291-2827</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Abdomen Abdominal surgery Aged Analysis Anesthesia Anesthesia, General Anesthesiology Area Under Curve Biology and Life Sciences Blood pressure Breast Neoplasms - pathology Breast Neoplasms - surgery C-reactive protein C-Reactive Protein - metabolism Colon Colonic Diseases - pathology Colonic Diseases - surgery Complications Correlation analysis Female Heart Heart surgery Humans Joint surgery Laparoscopy Laparoscopy - adverse effects Levels Linear Models Male Mastectomy Mastectomy - adverse effects Medical personnel Medicine Medicine and Health Sciences Middle Aged Ostomy Pain Pain perception Physical Sciences Postoperative complications Postoperative Complications - etiology Postoperative Period Prediction models Proteins Regression analysis Remifentanil Research and Analysis Methods Retrospective Studies ROC Curve Severity of Illness Index Stress response Surgery Thoracic surgery |
| title | Prediction of early C-reactive protein levels after non-cardiac surgery under general anesthesia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T03%3A20%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prediction%20of%20early%20C-reactive%20protein%20levels%20after%20non-cardiac%20surgery%20under%20general%20anesthesia&rft.jtitle=PloS%20one&rft.au=Nakamoto,%20Shiroh&rft.date=2019-12-02&rft.volume=14&rft.issue=12&rft.spage=e0226032&rft.epage=e0226032&rft.pages=e0226032-e0226032&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0226032&rft_dat=%3Cgale_plos_%3EA607357784%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2320830705&rft_id=info:pmid/31790508&rft_galeid=A607357784&rft_doaj_id=oai_doaj_org_article_98f17d90447e4c4786dbf818a8c10fba&rfr_iscdi=true |