Using post‐operative trend in C‐reactive protein to predict fistula in neopharyngeal repairs following laryngectomy and pharyngectomy surgery in fifty‐five patients

An external validation of C‐reactive protein reduction as a predictor of healing following laryngopharyngectomy

“…Given this, they have postulated that assessing CRP trend can be both sensitive and specific in predicting PCF formation as soon as day 5 post-operatively. 7 More specifically, they concluded that after daily postoperative CRP measurements, if the day 5 CRP had dropped by 35% from the previous highest recorded concentration, then there was a 97% likelihood of favourable anastomosis healing without fistula. This should subsequently allow earlier restart of oral intake, accelerating recovery and reducing hospital length of stay.…”

“…CRP is an acute phase protein of hepatic origin that increases with inflammation, tissue injury and infection, and decreases in concentration over 20 h once the initial stimulus ends. Given this, they have postulated that assessing CRP trend can be both sensitive and specific in predicting PCF formation as soon as day 5 post‐operatively 7 . More specifically, they concluded that after daily post‐operative CRP measurements, if the day 5 CRP had dropped by 35% from the previous highest recorded concentration, then there was a 97% likelihood of favourable anastomosis healing without fistula.…”

“…A recently published retrospective cohort study of 55 patients identified post-operative C-reactive protein (CRP) concentrations could predict PCF as soon as day 5. 7 More specifically, if the post-operative day 5 CRP concentration dropped by more than 35% from the highest previously recorded post-operative CRP concentration, this had a positive predictive value of 97% that the patient would heal without a fistula. Employing this diagnostic tool could accelerate early feeding and form a component in an enhanced recovery programme for patients undergoing laryngectomy surgery.…”