C-reactive protein and early diagnosis of anastomotic leakage in colorectal surgery: An evolving standard?

INTRODUCTION AND AIMS: Anastomotic leakage is a critical complication in colorectal surgery, significantly associated with postoperative morbidity and mortality. Early detection of at-risk patients is essential for optimizing clinical outcomes. The present study investigates the utility of C-reactive protein (CRP) as a predictive inflammatory biomarker for anastomotic leakage.

MATERIALS AND

METHODS

A retrospective observational study was conducted at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, analyzing 95 patients who underwent colorectal surgery within the time frame of March 2023 and July 2024. CRP levels were measured on postoperative days 1, 3, and 5. The predictive capacity was measured through ROC curves, determining the optimum cutoff points with the Youden index.

RESULTS

CRP on day 3 showed an AUC of 0.91, with an optimum cutoff point of 18.69 mg/l (Youden index = 0.73). On day 5, the AUC was 0.93, with a cutoff point of 14.25 mg/l (Youden index = 0.73). Both measurements showed high sensitivity and specificity for predicting anastomotic leakage.

CONCLUSION

Elevated CRP levels on postoperative days 3 and 5 emerged as robust predictors of anastomotic leakage, potentially guiding early interventions and improving patient prognosis.