Abstract | BACKGROUND: Postoperative intra-abdominal septic complications are difficult to manage in Crohn's disease, which makes prevention especially important. OBJECTIVE: The purpose of this study was to examine the risk factors for intra-abdominal septic complications after primary anastomosis for Crohn's disease and to seek a practical predictive index for intra-abdominal septic complications. DESIGN: This was a retrospective study. SETTINGS: The study was conducted in a tertiary referral hospital. PATIENTS: Based on a computerized database of 344 patients with Crohn's disease who underwent primary anastomosis between 2004 and 2013, the patients were placed into an intra-abdominal septic complications group and a group without intra-abdominal septic complications. MAIN OUTCOME MEASURES: Univariate and multivariate analyses were performed to identify risk factors, and the predictive accuracy of possible predictors was assessed using receiver operating characteristic curves. RESULTS: Overall, 39 patients (11.34%) developed intra-abdominal septic complications. Preoperative C-reactive protein level >10 mg/L was found to be an independent risk factor (p < 0.01) for intra-abdominal septic complications. For prediction of intra-abdominal septic complications, receiver operating characteristic curve analysis showed that a C-reactive protein cutoff of 14.50 mg/L provided negative and positive predictive values of 96.84% and 34.07%. In addition, the change in C-reactive protein levels over the 2 weeks before surgery was greater in the intra-abdominal septic complications group than the group with no intra-abdominal septic complications (p < 0.01), and the directions of change were opposite, upward in the former and downward in the latter. Apart from being a risk factor for intra-abdominal septic complications (p < 0.01), receiver operating characteristic curve analysis showed that the change in C-reactive protein levels before surgery had a negative predictive value for intra-abdominal septic complications of 98.66% and a positive predictive value of 76.09%. LIMITATIONS: This was a retrospective study. CONCLUSIONS: Changes in C-reactive protein before surgical treatment of Crohn's disease could serve as a practical predictive index for postoperative intra-abdominal septic complications.
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Authors | Lugen Zuo, Yi Li, Honggang Wang, Weiming Zhu, Wei Zhang, Jianfeng Gong, Ning Li, Jieshou Li |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 58
Issue 8
Pg. 775-81
(Aug 2015)
ISSN: 1530-0358 [Electronic] United States |
PMID | 26163957
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Abdominal Abscess
(epidemiology, metabolism)
- Adolescent
- Adult
- Anastomosis, Surgical
- Anastomotic Leak
(epidemiology, metabolism)
- C-Reactive Protein
(metabolism)
- Colectomy
- Crohn Disease
(metabolism, surgery)
- Decision Support Techniques
- Digestive System Surgical Procedures
- Female
- Humans
- Intestinal Fistula
(epidemiology, metabolism)
- Intestine, Small
(surgery)
- Male
- Postoperative Complications
(epidemiology, metabolism)
- Prognosis
- Regression Analysis
- Retrospective Studies
- Risk Factors
- Sepsis
(epidemiology, metabolism)
- Young Adult
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