The role of CRP in the diagnosis of postoperative complications in rectal surgery

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00098892%3A_____%2F21%3AN0000119" target="_blank" >RIV/00098892:_____/21:N0000119 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/61989592:15110/21:73608876

Výsledek na webu

<a href="https://ppch.pl/resources/html/article/details?id=212173&language=en" target="_blank" >https://ppch.pl/resources/html/article/details?id=212173&language=en</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.5604/01.3001.0014.6591" target="_blank" >10.5604/01.3001.0014.6591</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The role of CRP in the diagnosis of postoperative complications in rectal surgery

Popis výsledku v původním jazyce

Introduction: Postoperative complications of rectal resections classified as grade III or higher according to Clavien-Dindo system, which also include anastomotic leaks, are usually life-threatening conditions. Delayed diagnosis may account for almost 18% of deaths. Due to nonspecific clinical signs in the early postoperative period, diagnosing these complications may truly be a challenge for clinicians. Nowadays, with the implementation of the ERAS protocol (enhanced recovery after surgery) and efforts concentrated on quickly delivered treatment to patients suffering from the above-mentioned complications, an appropriate marker with high specificity is required. Postoperative levels of C-reactive protein (CRP) in blood serum seem promising in this aspect. Aim: The presented study aimed to determine the cut-off level of serum CRP as a possible predictive factor for early diagnosis of serious postoperative complications associated with rectal resections. This could also lead clinicians to the diagnosis of anastomotic leak after other possible options are ruled out. Material and methods; This study is a retrospective observational analysis of patients who underwent open resection of rectal cancer during a one-year period. Collected data included risk factors (age, gender, BMI, bowel preparation), record of complications and CRP serum levels. Results: The study included 162 patients. Uncomplicated postoperative course was observed in 58 patients (35.8%). Complications were present in 104 cases (64.2%), including surgical site infections (16.7%) and anastomotic leak (9.9%). The mortality rate was 2.5%. Serum CRP threshold predicting relevant complications reached a sensitivity of 83.3% and specificity of 82.7% on POD 4, with a 175.4 mg/L cut-off value, burdened with a 95.7% negative predictive value. Conclusion: Postoperative serum CRP may be used as a good predictor of infectious complications, including anastomotic leaks. Measuring CRP levels in the early postoperative period may facilitate identification of low-risk patients ensure early and safe discharges from hospital after rectal resections.

Název v anglickém jazyce

The role of CRP in the diagnosis of postoperative complications in rectal surgery

Popis výsledku anglicky

Introduction: Postoperative complications of rectal resections classified as grade III or higher according to Clavien-Dindo system, which also include anastomotic leaks, are usually life-threatening conditions. Delayed diagnosis may account for almost 18% of deaths. Due to nonspecific clinical signs in the early postoperative period, diagnosing these complications may truly be a challenge for clinicians. Nowadays, with the implementation of the ERAS protocol (enhanced recovery after surgery) and efforts concentrated on quickly delivered treatment to patients suffering from the above-mentioned complications, an appropriate marker with high specificity is required. Postoperative levels of C-reactive protein (CRP) in blood serum seem promising in this aspect. Aim: The presented study aimed to determine the cut-off level of serum CRP as a possible predictive factor for early diagnosis of serious postoperative complications associated with rectal resections. This could also lead clinicians to the diagnosis of anastomotic leak after other possible options are ruled out. Material and methods; This study is a retrospective observational analysis of patients who underwent open resection of rectal cancer during a one-year period. Collected data included risk factors (age, gender, BMI, bowel preparation), record of complications and CRP serum levels. Results: The study included 162 patients. Uncomplicated postoperative course was observed in 58 patients (35.8%). Complications were present in 104 cases (64.2%), including surgical site infections (16.7%) and anastomotic leak (9.9%). The mortality rate was 2.5%. Serum CRP threshold predicting relevant complications reached a sensitivity of 83.3% and specificity of 82.7% on POD 4, with a 175.4 mg/L cut-off value, burdened with a 95.7% negative predictive value. Conclusion: Postoperative serum CRP may be used as a good predictor of infectious complications, including anastomotic leaks. Measuring CRP levels in the early postoperative period may facilitate identification of low-risk patients ensure early and safe discharges from hospital after rectal resections.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Polish Journal of Surgery/Polski przeglad chirurgiczny

ISSN

0032-373X

e-ISSN

2299-2847

Svazek periodika

93

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

PL - Polská republika

Počet stran výsledku

7

Strana od-do

7-13

Kód UT WoS článku

000718243600011

EID výsledku v databázi Scopus

2-s2.0-85116772092