Tanweer Ahmed, Zakia Nehal, Imran Khan, Muhammad Mansoor Iqbal, Muhammad Iqbal Khan, Surghra Perveen.
Importance of C-Reactive Protein as a Clinical Diagnostic Tool for the Recognition of Anastomotic Leakage in patients Undergoing Large Bowel Anastomosis.
J Surg Pak Jan ;24(2):95-8.

Objective: To determine the diagnostic importance of C-reactive protein (CRP) in prediction of anastomotic leak in subjects who underwent large bowel anastomosis with CT scan taken as a gold standard. Study design: Cross sectional study. Place & Duration of study: Department of Surgery, Unit I, Jinnah Postgraduate Medical Centre Karachi, from February 2017 to August 2017. Methodology: A total of 115 patients (both male and female) of age group 13-50 years who underwent large bowel anastomosis either electively or in emergency with minimum intra peritoneal contamination, were enrolled. Serum CRP values were acquired on postoperative day (POD) 5 and values >100 mg/L were considered indicative of anastomotic leak out. A CT scan was done for confirmation and occurrence of hyperdense region considered as an anastomotic leak. Results: Mean age of the subjects was 43.26 +-8.01 year. Males were more commonly underwent surgery (n=73 - 63.5%) as compared to females (n=42 - 36.5%). Anastomotic leakage utilizing CRP was observed in 23 (20%) subjects. On the other hand 18 (15.7%) subjects were observed as an indicator of anastomotic leakage utilizing CT Scan. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall diagnostic accuracy were found as 61.11%, 87.63%, 47.83%, 92.39% and 83.47% respectively. Conclusion: the diagnostic precision of C-reactive protein was found in recognition of anastomotic leak in patients with large bowel anastomosis considering CT scan as a gold standard.

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