C-Reactive Protein on Postoperative Day 1: a Predictor of Early Intra-abdominal Infections After Bariatric Surgery.

Kröll, Dino; Nakhostin, Dominik; Stirnimann, Guido; Erdem, Suna; Haltmeier, Tobias; Nett, Philipp C.; Borbély, Yves Michael (2018). C-Reactive Protein on Postoperative Day 1: a Predictor of Early Intra-abdominal Infections After Bariatric Surgery. Obesity surgery, 28(9), pp. 2760-2766. Springer-Verlag 10.1007/s11695-018-3240-x

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BACKGROUND Early intra-abdominal infections (IAI) compromise short-term outcomes in bariatric surgery. The timely detection of IAI is challenging but essential to prevent major sequelae of such complications. C-reactive protein (CRP) is a reliable marker for detecting IAI after colorectal surgery. In bariatric surgery, data on CRP as a marker for IAI are limited, particularly for postoperative day one (POD1). OBJECTIVE The objective of this study was to assess CRP on POD1 as a predictor for early IAI (within 7 days following surgery) in patients after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB). METHODS Patients with bariatric surgery between 08/2010 and 06/2017 were included. The predictive capacity of CRP for early IAI was determined using a receiver operating characteristics (ROC) analysis. RESULTS In 523 patients (68.5% female, LSG = 358, LRYGB = 165), 16 (3%) early IAI were observed. ROC analysis revealed a significant predictive capacity of POD1 CRP for early IAI, with a sensitivity and a specificity of 81.2 and 94.3%, respectively, at a CRP cut-off value of 70 mg/L. In patients with confirmed early IAI, 81.3% had a CRP level ≥ 70 mg/L (LSG 85.7%, LRYGB 77.8%). The negative predictive value for a CRP level < 70 mg/L was 99.4% overall and was 100 and 98% for LSG and LRYGB, respectively. CONCLUSION In patients with a CRP level < 70 mg/L on POD1, early IAI can be excluded with high accuracy in bariatric patients. Thus, early postoperative CRP may be used to assess the risk of early IAI in enhanced recovery programs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Kröll, Dino; Nakhostin, Dominik; Stirnimann, Guido; Erdem, Suna; Haltmeier, Tobias; Nett, Philipp C. and Borbély, Yves Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0960-8923

Publisher:

Springer-Verlag

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

11 Dec 2018 15:55

Last Modified:

07 Feb 2019 05:40

Publisher DOI:

10.1007/s11695-018-3240-x

PubMed ID:

29679338

Uncontrolled Keywords:

C-reactive protein Intra-abdominal infections Organ space surgical site infections Postoperative complications ROC curve analysis Roux-en-Y gastric bypass Sleeve gastrectomy

BORIS DOI:

10.7892/boris.120318

URI:

https://boris.unibe.ch/id/eprint/120318

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