C-reactive protein 2 days after laparoscopic gastric bypass surgery reliably indicates leaks and moderately predicts morbidity
| Autor: | Ulrich Beutner, Patrick Folie, Philipp Bisang, Bernd Schultes, Rene Warschkow, Martin Thurnheer, Bruno M. Schmied, Ignazio Tarantino |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Leak medicine.medical_specialty Time Factors Laparoscopic gastric bypass Gastric Bypass Anastomotic Leak Severity of Illness Index Medicine Humans Postoperative Period Radiological imaging Retrospective Studies Receiver operating characteristic biology business.industry C-reactive protein Gastroenterology Area under the curve Postoperative complication Middle Aged Prognosis Confidence interval Surgery Obesity Morbid C-Reactive Protein biology.protein Female Laparoscopy Morbidity business Biomarkers Switzerland Follow-Up Studies |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 16(6) |
| ISSN: | 1873-4626 |
| Popis: | The aim of the present study was to evaluate whether serum C-reactive protein (CRP) is a useful predictor of early post-operative complications, particularly of intestinal leaks after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. The present study was a retrospective analysis of a prospectively maintained database with 809 patients who underwent LRYGB from 2002 until 2011. For 410 of these patients, at least one CRP measurement within the first seven post-operative days was available. The diagnostic value was determined by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Forty-nine of 410 patients (12.0 %; 95 % confidence intervals [95 % CI], 9.2–15.5 %) developed surgery-related complications. Leaks occurred in 17 patients (4.1 %; 95 % CI, 2.6–6.5 %) at a median of 5 days after surgery. CRP levels 2 days after surgery showed the highest diagnostic value for post-operative complications (AUC, 0.74; 95 % CI, 0.60–0.89). Sensitivity was 0.53 (95 % CI, 0.31–0.74) and specificity was 0.91 (95 % CI, 0.79–0.96) on day 2 (cutoff level, 229 mg/l). The sensitivity for intestinal leaks was 1.00 (95 % CI, 0.51–1.00). CRP on post-operative day 2 is a valuable predictor of post-operative complications, in particular intestinal leaks. Radiological imaging studies for intestinal leaks could be restricted to patients with CRP values exceeding 229 mg/l. |
| Databáze: | OpenAIRE |
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