The predictive factors for postoperative intra-abdominal septic complications after intestinal resection in patients with Crohn′s Disease

Abstract

Objective To investigate the predictive factors for postoperative intra-abdominal septic complications (IASCs) after intestinal resection in patients with Crohn′s Disease (CD). Methods Clinical data from patients who underwent intestinal resection for CD at Sir Run Run Shaw Hospital between June 2011 and July 2016 were retrospectively analysed. The patients were divided into IASCs group and non-IASCs groups by whether suffering from postoperative IASCs. Univariate analysis and multivariate logistic regression analysis were performed to identify the predictive factors for postoperative IASCs, and the receiver operating characteristic curve (ROC) was used to analyse the diagnostic value of the results. Results Among one hundred and seventy-three patients who underwent intestinal resection for CD, 15(8.7%) patients experienced postoperative IASCs. The results of univariate and multivariate analysis showed that preoperative CRP≥10 mg/L (OR=4.920, 95%CI: 1.137-21.287, P=0.033) was an independent trisk factor for postoperative IASCs, and the laparoscopic surgery (OR=0.070, 95%CI: 0.007-0.701, P=0.024) was the independent protective factor for postoperative IASCs. By analyzing ROC curve, preoperative CRP level had the diagnostic value of predicting the postoperative IASCs. The areas under the ROC curves of preoperative CRP for postoperative IASCs were 0.729 with an optimal diagnostic cut-off value of 10.75 mg/L, and with sensitivity of 80.0% and a specificity of 67.1%. Conclusions Preoperative CRP level is an independent risk factor for postoperative IASCs, and laparoscopic surgery is an independent protective factor for IASCs. Key words: Crohn disease; Focal infection; C-reactive protein; Postoperative complications