Preoperative Evaluation of Acute Phase Protein Response to Surgery by Serum Protein Profile

Tetsuji Fujita

First Department of Surgery, The Jieki University School of Medicine

The preoperative nutritional status was assessed on the basis of serum acute phase proteins (serum protein profile) in 50 patients who underwent gastrectomy, colectomy or hepatectomy, and the incidence of postoperative infections was analyzed in conjunction with the preoperative protein levels. Postoperative responses of 16 patients whose third component of complement (C₃) and haptoglobin (Hp) levels were normal and of 14 patients whose C₃ and Hp levels were subnormal. In 39 patients (78% of all patients), at least one of the acute phase proteins C₃, Hp or prealubumin was lower than normal. These patients tended to have more postoperative infections. The expected postoperative increase in serum C-reactive protein and α₁-acid glycoprotein was attenuated in patients with preopertively low serum C₃ and Hp levels. In conclusion, part of the response to surgery is shown to be impaired in patients with preoperatively low serum positive acute phase proteins (C₃ and Hp). Therefore, in addition to measurement of negative acute phase proteins, positive acute phase proteins should be measured before surgery.

Key words
serum protein profile, response to surgery, third component of complement, haptoglobin, malnutrition

Reprint requests
Tetsuji Fujita First Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi, Minatoku, Tokyo, 105 JAPAN

Accepted
November 20, 1991

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