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Cirugía y cirujanos

versión On-line ISSN 2444-054Xversión impresa ISSN 0009-7411

Resumen

BORRAEZ-SEGURA, Bernardo et al. Increase in C-reactive protein as early predictor of anastomotic leakage in abdominal surgery. Cir. cir. [online]. 2022, vol.90, n.6, pp.759-764.  Epub 09-Dic-2022. ISSN 2444-054X.  https://doi.org/10.24875/ciru.21000597.

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.

Palabras llave : C-reactive protein; Predictive value of tests; Anastomotic leak; Digestive system surgical procedures.

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