Increase in C-reactive protein as early predictor of anastomotic leakage in abdominal surgery.

Abstract

OBJECTIVES:

The aim of this study was to evaluate the role of the C-reactive protein (CRP) and white cell count (WC) in the prediction of anastomotic leakage (AL) in major abdominal surgery.

METHODS:

Multicenter, prospective, and observational study of adult patients who underwent major abdominal surgery. CRP and hemogram were measured after post-operative day (POD) 3 and POD 5. Complications were classified according to the Clavien-Dindo classification. Diagnostic accuracy was evaluated by the area under the receiver operating characteristic curve (AUC).

RESULTS:

A total of 97 patients were included in the study. The mean age was 63 ± 12 years and 47 (48%) were male. Colorectal (56%) and gastric cancer (36%) were the most frequent diagnoses. About 23% had post-operative complications, of which 5% had AL. The most significant predictive factor was the increase in CRP ≥ 2.84 mg/L among POD 3 and 5 (AUC, 0.99, sensitivity, 95.6%, specificity, 100%, positive likelihood ratio, 23.0). The accuracy of the other biomarkers was lower, CRP on POD 3 (AUC, 0.55), on POD 5 (AUC, 0.93), WC on POD 3 (AUC, 0.33), and POD 5 (AUC, 0.35).

CONCLUSION:

The increase of CRP among POD 3 and 5 was an early predictor of AL in adult patients with major abdominal surgery.

• Authors: Bernardo Borraez-Segura, Juan P Orozco-Hernández, Felipe Anduquia-Garay, Natalia Hurtado-Hurtado, Jessica Soto-Vásquez, Ivan D Lozada-Martinez
• Journal: Cirugia y cirujanos (Cir Cir) Vol. 90 Issue 6 Pg. 759-764 ( 2022) ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Aumento de la proteína C reactiva como predictor precoz de fuga anastomótica en cirugía abdominal.
• PMID: 36472846 (Publication Type: Observational Study, Multicenter Study, Journal Article)
• Copyright: Copyright: © 2022 Permanyer.

Chemical References

• C-Reactive Protein

Topics

• Humans
• Male
• Middle Aged
• Aged
• Female
• C-Reactive Protein
• Prospective Studies