Serum transferrin levels – A predictive marker of spontaneous closure and mortality in patients with enterocutaneous fistulae

Abstract

Background and study aims A fistula is a communication between two epithelialised surfaces. Fistulae may be classified based on anatomic, physiologic or aetiologic criteria. Postoperative fistulae account for approximately 80% of enterocutaneous fistulae. There are numerous features including laboratory parameters that may enable the prediction of spontaneous closure in patients with enterocutaneous fistulae. The aim of this study was to determine whether serum transferrin levels are a predictive marker for spontaneous closure of enterocutaneous fistulae, as well as for patients’ morbidity and mortality. Patients and methods A prospective study including 92 patients with enterocutaneous fistulae (recruitment from March 2000 to February 2009) was done and serum transferrin levels were assessed on the day of presentation with the enterocutaneous fistula. All patients were followed-up till their final outcome. Statistical significance was determined by using the chi-square test. Results Spontaneous fistula closure rate was 66.67% in patients with serum transferrin levels >140 mg dl −1 and 18.33% in whom serum transferrin levels were <140 mg dl −1, and this was statistically highly significant. Mortality rate was 56.25% in patients with serum transferrin levels <140 mg dl −1 and 18.75% in whom serum transferrin levels were >140 mg dl −1 and the difference was statistically significant too. Conclusion Short-turnover proteins, such as serum transferrin, are useful in predicting which patients with enterocutaneous fistulae should undergo surgery despite anatomic and physiological criteria favourable for spontaneous closure and which patients should not.