Procalcitonin and c-reactiveprotein as earlypredictors of anastomotic leakage in colorectal surgery: aprospective trial: P047

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Aim:To evaluate the role ofprocalcitonin (PCT) and C-reactiveprotein (PCR) in the earlyprediction of anastomotic leakage (AL) in colorectal surgery.Method:A series of 212 patients undergone colorectal surgery at our specialized Unit was analyzed. The following data were collected: demographic, surgical, ASA, POSSUM and morbidity. During the first five postoperative days, the value of PCT, PCR, leucocytes, platelets and vital signs were daily evaluated. ROC curve was used for statistical analysis.Results:AL was detected in 17 (8.0%) patients; 8 (3.8%) of them had a major (need for drainage or reoperation) AL. None of the variables evaluated were reliable indicators for early detection of AL (maximum area under the curve (AUC) < 0.75). However, considering only major AL, PCT (at day 4) and PCR (at day 3) resulted to be reliablepredictors (P < 0.0001 and P = 0.003 respectively, AUC = 0.893 and 0.827 respectively). In particular PCT, at a cut-off value of 0.57 ng/ml, showed to have a 87.5% sensibility and a 80.5% specificity.Conclusion:The most reliable variable forprediction of AL is PCT. An elevated PCT value at the 4th postoperative should dictate a careful evaluation of the patient before discharge.

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