Predictive Accuracy of C-reactive Protein as an Early Indicator of Leakage After Anastomosis and Primary Repair in Gastrointestinal Surgery

Background Anastomotic leakage after gastrointestinal surgery is a significant postoperative complication that leads to increased morbidity and mortality. C-reactive protein (CRP) has been used previously as a predictive marker of anastomotic leakage in gastrointestinal surgeries. Its short half-lif...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e71107
Main Authors: Mayank, Shaswat, Ekka, Nishith M, Sinha, Dipendra K, Kumar, Binay, Kumar, Nabu, Ranjan, Abhinav, Verma, Somya, Darad, Srishti, Kumar, Sourabh, Mayank, Niharika
Format: Article
Language:English
Subjects:
Abdomen
Age groups
Cancer surgery
Chi-square test
Data collection
Females
Gastrointestinal surgery
Laboratories
Medical prognosis
Mortality
Ostomy
Peritonitis
Proteins
Surgical anastomosis
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Summary:Background Anastomotic leakage after gastrointestinal surgery is a significant postoperative complication that leads to increased morbidity and mortality. C-reactive protein (CRP) has been used previously as a predictive marker of anastomotic leakage in gastrointestinal surgeries. Its short half-life makes it a reliable marker for postoperative complications, rapidly returning to normal values as the patient recovers. We conducted this study to evaluate the predictive accuracy of serum CRP levels in predicting anastomotic leaks in patients undergoing gastrointestinal repair surgeries. Methods Ninety-six gastrointestinal surgeries involving anastomoses and primary repairs were included in the study. CRP was taken serially from postoperative days (POD) 1 to 7. Patients were divided into two groups based on postoperative outcomes: leakage and non-leakage. The receiver operating characteristic (ROC) curve of CRP levels with leak and mortality was plotted to find a threshold value for leak and mortality. Results Out of 96 patients included in the study, Group B (non-leakage) consisted of 78 patients (81.3%), while Group A (leakage) comprised 18 patients (18.7%). ROC analysis identified a CRP cutoff of 127 mg/L on POD 5, with high sensitivity (80%) and high specificity (80%) indicating a high likelihood of leakage above this threshold. Conclusion This study underscores the importance of monitoring CRP levels in the postoperative period, particularly on POD 5, as a non-invasive and cost-effective tool for the early detection of anastomotic leaks.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.71107