Predictive value of inflammatory markers for postoperative recovery following colorectal surgery.

Abstract

Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172mg/l on postoperative day 3 were associated with postoperative recovery within 5days. This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care. One hundred sixty-height patients, with a mean age of 65years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5days. C-reactive protein levels < 172mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5days. Ninety-five percent of patients with C-reactive protein < 172mg/L at postoperative day 3 had no severe postoperative complications. Levels of C-reactive protein < 172mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.