Diagnostic value of serial measurement of c-reactive protein in serum and matrix metalloproteinase-9 in drainage fluid in the detection of infectious complications and anastomotic leakage in patients with colorectal resection

Kostić, Zoran; Panišić, Marina; Milev, Bosko; Mijusković, Z; Slavković, Damjan; Ignjatović, Miroljub

doi:10.2298/vsp140723011k

Cited by 15 publications

(18 citation statements)

References 42 publications

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“…Secretion begins at 4 to 10 hours following inflammatory stimulation, peaks in the plasma at 48 hours, and returns to baseline after the inflammatory stimulus ceases 20,21,24,25 . Because of its short half-life (19 hours), CRP is a reliable marker following surgical procedures [25][26][27] .…”

mentioning

confidence: 99%

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Messias¹,

Botelho

Saad

et al. 2020

Sci Rep

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Anastomotic leakage is a complication of colorectal surgery. c-reactive protein (cRp) is an acutephase marker that can indicate surgical complications. We determined whether serum cRp levels in patients who had undergone colorectal surgery can be used to exclude the presence of anastomotic leakage and allow safe early discharge. We included 90 patients who underwent colorectal surgery with primary anastomosis. Serum cRp levels were measured retrospectively on postoperative days (poDs) 1-7. Patients with anastomotic leakage (n = 11) were compared to those without leakage (n = 79). We statistically analysed data and plotted receiver operating characteristic curves. the incidence of anastomotic leakage was 12.2%. Diagnoses were made on PODs 3-24. The overall mortality rate was 3.3% (18.2% in the leakage group, 1.3% in the non-leakage group; P < 0.045). CRP levels were most accurate on POD 4, with a cutoff level of 180 mg/L, showing an area under the curve of 0.821 and a negative predictive value of 97.2%. Lower CRP levels after POD 2 and levels <180 mg/L on POD 4 may indicate the absence of anastomotic leakage and may allow safe discharge of patients who had undergone colorectal surgery with primary anastomosis.

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mentioning

confidence: 99%

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Messias¹,

Botelho

Saad

et al. 2020

Sci Rep

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“…Diagnosis of AL was made between POD 2 and POD 13 (median POD 5). Although this showed promise, in a subsequent study Kostic et al . did not find any statistically significant changes in MMP‐9 levels in patients with AL on POD 1, 3, 5 and 7.…”

Section: Resultsmentioning

confidence: 87%

“…Six studies 16,24,30,31,35,49 evaluated peritoneal and systemic biomarkers of ischaemia in the context of AL following colorectal surgery. Matthiessen and colleagues 31 reported a statistically significant increase in the lactate/pyruvate (L/P) ratio on POD 5 and 6 in four patients with AL diagnosed up to POD 14 (median POD 6), and another three with AL diagnosed after discharge (median POD 20, range [18][19][20][21][22].…”

Section: Biomarkers Of Ischaemiamentioning

confidence: 99%

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Systematic review of the role of biomarkers in diagnosing anastomotic leakage following colorectal surgery

Su'a

Mikaere

Rahiri

et al. 2017

British Journal of Surgery

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“…Sonuç olarak, tekrarlı CRP ölçümlerinden yararlanmanın tanı koymadan çok antibiyotik kullanımına karar vermeye yardımcı olabileceğini belirtmişlerdir 43. Kostić ve ark., kalın bağırsak kanseri olan ve kalın bağırsağından parça alınan bireylerde tekrarlı CRP ölçümlerinin, kolorektal cerrahide bulaşıcı komplikasyonların tespitinde önemli olup olmadığını araştırmışlardır 44. Bu amaçla bireylerden CRP değerleri, parça alımı operasyonu sonrasındaki birinci, üçüncü, beşinci ve yedinci günlerde alınmış, ölçüm alınan her bir gün için ayrı ayrı klasik ROC Eğrisi analizi uygulanmış, sonuç olarak CRP'nin tekrarlı ölçümlerinin, kolorektal cerrahide bulaşıcı komplikasyonu olan bireylerin erken tanısında yararlanılabileceğini belirtmişlerdir.…”

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Investigating Factors Affecting Diagnostic Performance of Serial C-Reactive Protein Measurements by Using Joint Modeling Approach

Konar¹,

Karaismailoğlu²,

Portakal³

et al. 2018

Turkiye Klinikleri J Biostat

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C-Reaktif Protein (CRP), erişkin yoğun bakımda yatan hastalardan tekrarlı ölçümleri sıklıkla alınan bir belirteçtir. Bu çalışmada söz konusu belirtecin tekrarlı ölçümlerinin, izlem süresi olarak belirlenen 30 günlük süre sonunda yoğun bakımda ölüm olgusunu kestirmedeki tanısal performansını etkileyen faktörlerin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Hacettepe Üniversitesi Erişkin Yoğun Bakım Ünitesi'nde yatan hastalara ait tekrarlı CRP ölçümleri ile sağkalım sürelerinin eş zamanlı olarak modellenebilmesi için birleşik modelleme yaklaşımı kullanılmıştır. Bu yaklaşımdan yararlanılarak, belirteçlerin tanısal performanslarının belirlenebilmesi için zamana bağlı ROC Eğrisi altında kalan alan (zb-EAA) değerlendirilmiştir. Bulgular: Tekrarlı CRP ölçümlerinin izlem süresi sonunda yoğun bakımda ölümü kestirmedeki tanısal performansı orta düzeyde bulunmuştur. Bununla birlikte, sağkalım zamanına ait dağılım türünün ya da uzunlamasına veri bölümünde rassal etkiler kısmının daha detaylı olarak modellenmesinin tekrarlı CRP ölçümlerinin tanısal performansına etki etmediği saptanmış, en yüksek performansın standart birleşik model ile elde edildiği belirlenmiştir. Sonuç: Analiz sonuçlarına göre, optimum tanısal doğruluğun elde edilebilmesi için, standart birleşik modelin kullanılması önerilmekle birlikte, söz konusu modelin uzunlamasına bölümünde rassal eğim ve rassal kesim noktası modelinin; modelin sağkalım kısmında ise, parametrik bir dağılım olmasından dolayı Piecewise-Constant dağılımının kullanılması önerilmektedir. Anahtar Kelimeler: Zamana-bağlı ROC eğrileri; belirteç; zamana-bağlı eğri altında kalan alan; birleşik model; sağkalım zamanı; CRP ABSTRACT Objective: Serial C-Reactive Protein (CRP) measurements are frequently taken in Adult Intensive Care Units. In this study it's aimed to evaluate the factors affecting diagnostic accuracy of this biomarker's serial measurements in predicting the risk of death at Intensive Care Units (ICU) at the end of follow-up period, 30 days. Material and Methods: Joint Modelling Approach is used to model repeated CRP measurements taken from Hacettepe University Adult Intensive Care Units and survival times simultaneously. With the help of this model, time-dependent Area Under ROC Curve (td-AUC) values are calculated and assessed as diagnostic performance criteria. Results: Diagnostic performance of serial CRP values in predicting the risk of death is found as moderate. However, it's found that neither the distribution of survival times in survival sub-model nor utilizing more detailed function in random-effects part of longitudinal sub-model affect the diagnostic performance. Also it's determined that the highest diagnostic performance is obtained with standart standard joint model. Conclusion: To reach the highest diagnostic accuracy, standard joint model with Piecewise Constant Distribution in survival sub-model and random intercepts-random slope structure in longitudinal sub-model should be used.

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Diagnostic value of serial measurement of c-reactive protein in serum and matrix metalloproteinase-9 in drainage fluid in the detection of infectious complications and anastomotic leakage in patients with colorectal resection

Cited by 15 publications

References 42 publications

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Systematic review of the role of biomarkers in diagnosing anastomotic leakage following colorectal surgery

Investigating Factors Affecting Diagnostic Performance of Serial C-Reactive Protein Measurements by Using Joint Modeling Approach

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