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Published in: Obesity Surgery 12/2017

01-12-2017 | Original Contributions

Diagnostic Performance of C-Reactive Protein in Detecting Post-Operative Infectious Complications After Laparoscopic Sleeve Gastrectomy

Authors: Fadia Dib, Lara Ribeiro Parenti, Anne Boutten, David Hajage, Jean-Pierre Marmuse

Published in: Obesity Surgery | Issue 12/2017

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Abstract

Background

Gastric leak is the most common and dreaded post-operative infectious complication (PIC) after laparoscopic sleeve gastrectomy (LSG). Accurate identification of patients at risk postoperatively is of cardinal importance.

Objective

The aim of this study is to assess the diagnostic performance of C-reactive protein (CRP) in predicting PICs and the most optimal time to measure it.

Methods

CRP results were collected in patients undergoing LSG between 2011 and 2015. CRP was systematically measured on post-operative days (POD) 1, 3, and 5.

Results

Of 1326 patients, 42 (3.2%) developed a PIC at a median of 5 days after surgery. The incidence of leakage was 1.9%. The best area under the curve was observed on POD5 (0.87; 95% CI 0.77–0.96). At this time point, a cut-off of 115 mg/L yielded a sensitivity of 66.7% (95% CI 46.5–86.8%), a specificity of 95.1% (95% CI 93.9–96.3%), a positive and negative predictive values of 19.4% (95% CI 10.3–28.6%) and 99.4% (95% CI 99.0–100%), respectively, and a positive and negative likelihood ratios (LRs) of 13.62 and 0.35, respectively. The combination of sequential assessments of CRP on POD3 and 5 provided a sensitivity of 84.4% (95% CI 71.8–97.0%), a specificity of 91.1% (95% CI 89.5–92.8%), a positive and negative predictive values of 20.9% (95% CI 14.0–27.9%) and 99.5% (95% CI 99.1–99.9%), respectively, and a positive and a negative LRs of 9.58 and 0.17, respectively.

Conclusions

CRP may be useful to identify patients at risk of PICs after LSG and, therefore, to prompt early investigation. However, CRP does not help rule out PICs.
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Metadata
Title
Diagnostic Performance of C-Reactive Protein in Detecting Post-Operative Infectious Complications After Laparoscopic Sleeve Gastrectomy
Authors
Fadia Dib
Lara Ribeiro Parenti
Anne Boutten
David Hajage
Jean-Pierre Marmuse
Publication date
01-12-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2744-0

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