Cargando…
Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients
Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3–4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780083/ https://www.ncbi.nlm.nih.gov/pubmed/35055369 http://dx.doi.org/10.3390/jpm12010054 |
_version_ | 1784637743727378432 |
---|---|
author | Slavin, Moran Goldstein, Avigayil Raguan, Barak Rudnicki, Yaron Avital, Shmuel White, Ian |
author_facet | Slavin, Moran Goldstein, Avigayil Raguan, Barak Rudnicki, Yaron Avital, Shmuel White, Ian |
author_sort | Slavin, Moran |
collection | PubMed |
description | Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3–4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to determine whether postoperative CRP levels can be used to rule out anastomotic leaks in patients with Crohn’s disease and to set CRP threshold values for this population. Methods: This was a retrospective study of a population of Crohn’s disease patients who underwent surgery with bowel anastomoses at a single high-volume center between 1/2012 and 12/2017. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist. Results: Ninety-two operations were performed. A CRP level of 19.56 mg/dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a negative predictive value (NPV) of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p = 0.06). Conclusions: Mean CRP levels and CRP threshold values were indeed higher in the study population compared with those in colorectal cancer patients. Threshold values were set at 20.3 mg/dL on POD 3, 19.5 mg/dL on POD 4 and 16.7 mg/dL on POD 5. These values had high NPVs and can be used to rule out anastomotic leaks in patients with Crohn’s disease after surgery with bowel anastomosis. |
format | Online Article Text |
id | pubmed-8780083 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87800832022-01-22 Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients Slavin, Moran Goldstein, Avigayil Raguan, Barak Rudnicki, Yaron Avital, Shmuel White, Ian J Pers Med Article Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3–4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn’s disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to determine whether postoperative CRP levels can be used to rule out anastomotic leaks in patients with Crohn’s disease and to set CRP threshold values for this population. Methods: This was a retrospective study of a population of Crohn’s disease patients who underwent surgery with bowel anastomoses at a single high-volume center between 1/2012 and 12/2017. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist. Results: Ninety-two operations were performed. A CRP level of 19.56 mg/dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a negative predictive value (NPV) of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p = 0.06). Conclusions: Mean CRP levels and CRP threshold values were indeed higher in the study population compared with those in colorectal cancer patients. Threshold values were set at 20.3 mg/dL on POD 3, 19.5 mg/dL on POD 4 and 16.7 mg/dL on POD 5. These values had high NPVs and can be used to rule out anastomotic leaks in patients with Crohn’s disease after surgery with bowel anastomosis. MDPI 2022-01-05 /pmc/articles/PMC8780083/ /pubmed/35055369 http://dx.doi.org/10.3390/jpm12010054 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Slavin, Moran Goldstein, Avigayil Raguan, Barak Rudnicki, Yaron Avital, Shmuel White, Ian Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title | Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title_full | Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title_fullStr | Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title_full_unstemmed | Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title_short | Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn’s Disease Patients |
title_sort | postoperative crp levels can rule out anastomotic leaks in crohn’s disease patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780083/ https://www.ncbi.nlm.nih.gov/pubmed/35055369 http://dx.doi.org/10.3390/jpm12010054 |
work_keys_str_mv | AT slavinmoran postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients AT goldsteinavigayil postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients AT raguanbarak postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients AT rudnickiyaron postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients AT avitalshmuel postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients AT whiteian postoperativecrplevelscanruleoutanastomoticleaksincrohnsdiseasepatients |