Elevated serum C-reactive protein as a predictive factor for anastomotic leakage in colorectal surgery

Almeida, Ana Beatriz Albino de; Faria, Gil; Moreira, Herculano; Pinto-de-Sousa, João; Correia-da-Silva, Pedro; Maia, J. Costa

doi:10.1016/j.ijsu.2011.12.006

Cited by 118 publications

(116 citation statements)

References 26 publications

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“…However, the exact sensitivity and specificity of the marker had never been assessed in our center yet. The values of sensitivity and specificity obtained in our study were similar to those in other publications [14][15][16], except that our cut-off value was higher [18,19]. Furthermore, our results showed some small differences in sensitivity or specificity between certain subgroups of patients.…”

Section: Discussionsupporting

confidence: 90%

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Mik¹,

Dziki²,

Berut³

et al. 2017

Dig Surg

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Purpose: To assess the prognostic value of postoperative C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in the development of anastomotic leak (AL) in patients after surgery for colorectal cancer (CRC). Methods: Patients operated on for CRC between 2010 and 2014 were enrolled into the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPVs) were calculated for the CRP and NLR measured on the 4th postoperative day (POD). Results: Among 724 patients, AL was diagnosed in 33 (4.6%). The accuracy of CRP in the detection of AL using area under curve was 0.83 with the optimal cut-off value of 180 mg/L, sensitivity 75%, specificity 91%, PPV 52% and NPV 87%. Also, NLR on POD4 was higher in the AL group: 9.03 ± 4.13 vs. 4.45 ± 2.25; p = 0.0012; sensitivity 69%, specificity 78%, PPV 49%, NPV 88% at cut-off point of 6.5. Moreover, CRP and NLR on POD4 were significantly higher in patients who died in the postoperative period: 239 ± 24 mg/L vs. 199 ± 41 mg/L; p = 0.034 and 10.71 ± 2.08 vs. 8.65 ± 4.67; p = 0.029, respectively). Conclusions: CRP and NLR on POD4 possess the ability to predict the development of AL and postoperative mortality after CRC operation. Based on our results, high NPV might be indicative of patients with low risk of AL in their postoperative period.

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Section: Discussionsupporting

confidence: 90%

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Mik¹,

Dziki²,

Berut³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

show abstract

“…Similarly, C reactive protein may have a role in predicting the need for surgery in patients with abdominal pain,100101 or in identifying post-operative patients who develop a septic complication,102103104105 but the data are insufficient to recommend routine clinical use.…”

Section: Laboratory Measuresmentioning

confidence: 99%

Secondary peritonitis: principles of diagnosis and intervention

Ross

Matthay

Harris

2018

BMJ

119

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Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis.

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“…There was another study aimed to demonstrate the value of WBC in the identification of increased risk of AL after colorectal surgery. Comparison of postoperative serum WBC values did not show any significant differences between AL group and non-AL group until the POD6 [6]. Another two studied got the similar conclusion that WBC was not an ideal biomarker for predicting AL [10,14].…”

Section: White Blood Cell Countmentioning

confidence: 78%

“…According to the result, the diagnosis of AL was mainly between the 4th and 11th postoperative day (POD, mean 7th POD). The cut-off value of 140 mg/L on POD3 maximized the sensitivity (78%) and specificity (86%) of serum CRP in assessing the risk of leakage [6]. Serum CRP has been evaluated in other 11 studies [7][8][9][10][11][12][13][14][15][16][17].…”

Section: C-reactive Proteinmentioning

confidence: 99%

The value of biomarkers in early diagnosis of anastomotic leak following colorectal tumor resection: a review of the literature between 2012 and 2017

Ge¹,

Chen²

2017

Oncotarget

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Anastomotic leakage (AL) is one of the most serious complications of colorectal resection, causing sepsis, reducing overall in-hospital survival and increasing the risk of local and distant recurrences. So, early diagnosis of AL is very important. To improve the early diagnosis of AL following colorectal resection, a number of studies have investigated potential biomarkers to predict AL. In this review, we summarized the biomarkers, which had been shown to be useful in early diagnosis of AL. The results showed that c-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), cytokines, and so on were hot study biomarkers, which were proved to be reliable predictors of AL. Besides, drainage indexes such as microbiological study, potential of hydrogen (PH), carcinoembryonic antigen (CEA), and so on also helped to indicate early AL. Although there have been many studies on this field, rigorous homogeneous and prospective trials are demanded to explore ideal biomarkers to early diagnose AL.

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Elevated serum C-reactive protein as a predictive factor for anastomotic leakage in colorectal surgery

Abstract: According to these results, an early and persistent elevation of CRP after colorectal surgery with anastomosis, is a marker of anastomotic leakage. A cut-off value > 140 mg/L on POD3 maximizes sensitivity and specificity.

Cited by 118 publications

References 26 publications

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Secondary peritonitis: principles of diagnosis and intervention

The value of biomarkers in early diagnosis of anastomotic leak following colorectal tumor resection: a review of the literature between 2012 and 2017

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