Ninna H.G. Christensen* and Birgitte Brandstrup
Department of Surgery, Holbeak University Hospital, DenmarkFulltext PDF
Background: The aim was to investigate the rise of acute phase reactants; CRP, WBC, thrombocytes and cortisol, in patients with postoperative anastomotic leakage compared to patients with other infectious and noninfectious complications.Methods: Prospectively collected data from two clinical trials, including 318 patients undergoing colorectal surgery, were analyzed. Blood was sampled every day until discharge or postoperative day (POD) 7 and complications were registered every day during admission and with 30 days of follow-up.Results: Of 318 patients, 12 (3.7%) developed AL (anastomotic leakage) and 72 (22.6%) developed other infectious complications. No differences in basic characteristics were seen. CRP levels were significantly higher in patients with AL on POD 5 when compared to those who developed urinary tract infection and no complications. Patients with pneumonia had a significantly higher cortisol level at POD 3 compared to patients without complications. No significant difference was seen in the postoperative level of WBC and thrombocytes.Conclusion: Based on the level of CRP and cortisol, it is possible at POD 5 and 3 to detect whether a patient is at risk of developing an infectious complication. With the possible exception of UTI, there is, however, no significant difference in the CRP level between AL and other infectious complications. The level of cortisol was significantly higher at POD 3 for the patients developing pneumonia compared to the uncomplicated group, but this showed to be of a low diagnostic accuracy and of no use to diagnose neither pneumonia nor AL.
Anastomotic; Colorectal; Complications; Cortisol; CRP; Infectious; Leakage; Leukocytes
Christensen NHG, Brandstrup B. The Value of Acute Phase Reactants in the Early Diagnosis of Complications following Colorectal Resection. Clin Surg. 2016; 1: 1197.