C-reactive protein levels as a predictor for anastomotic success in post-operative intestinal resection surgery

Abstract

Background: C-reactive protein (CRP) is widely used as an early predictor of anastomotic complications such as anastomotic leakage (AL) after abdominal surgery. There are no data available regarding the AL in A.W.Sjahranie Regional General Hospital (RSUD AWS). This study analyzed the CRP values and their relationship with AL after bowel resection and anastomosis surgery at RSUD AWS Samarinda.Methods: This is an observational analytic cross-sectional study. Sample data were collected from the medical records of 40 patients who underwent bowel resection between May and December 2019. Patients were between 18-75 years old and showed clinical signs of AL. CRP laboratory data were examined on the fifth-day post-operation. After tabulation, the data were analyzed using Chi-square (Fisher’s exact) test, t-test, and receiver operating characteristic curve analysis.Results: The average sample age was 46.3 ± 1.31 years, with a 1:1 male and female ratio. The analysis showed that an increase in CRP values and white blood cell counts was not related to AL (p > 0.05). The mean CRP value of patients with AL (48.0±0.00 mg/L) was not significantly different if compared to non-AL patients (25.89 ± 18.93 mg/L) (p = 0.139). The CRP cut-off value of 36 mg/L had 100% sensitivity, 60.5% specificity, 71.7% positive predictive value and 100% negative predictive value with an area under the curve of 0.80 (p=0.153). These results showed that the CRP cut-off value of 36 mg/L couldn't be used as a predictor of AL.Conclusion: CRP level of 36 mg/L can be used as a predictor of non-AL; therefore, it can be used as a criterion for patient discharge.