Isa Basuki1 | M. Ihwan Kusuma2 | Bambang Suprapto3 | Joko Hendarto4
1Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia.
2Faculty of Medicine, Hasanuddin University-Dr. Wahidin Soedirohoesodo Central General Hospital
3Faculty of Medicine, Mulawarman University-A.W.Sjahranie Regional General Hospital
4Faculty of Medicine, Hasanuddin University Makassar 90245, Indonesia
E–mail address: isabasuki.ib@gmail.com
Abstract
C-reactive protein (CRP) is widely used as an early predictor of anastomotic complications such as anastomotic leakage (AL) after abdominal surgery. This study analysed the CRP values and their relationship with AL after bowel resection and anastomosis surgery. Sample data were collected from the medical records of 40 patients who underwent bowel resection at A.W. Sjahranie General Hospital, Samarinda, between May and December 2019. Patients were between 18–75 years old and showed clinical signs of AL. CRP laboratory data were examined on the fifth day post operation. After tabulation, the data were analysed using Chi-square, t-test and recerver operating characteristic curve analysis. The mean sample age was 46.3 ± 1.31 years with a male: female ratio of 1:1. Analysis showed that the surgery method, anastomosis type, lesion location, increase in CRP values and white blood cell counts we’re not related to AL (p > 0.05). The mean CRP value of patients with AL (48.0 ± 0.00 mg/L) was not significantly different if compared to non-AL patients (25.89 ± 18.93 mg/L) with p = 0.139. The CRP cut-off value of 36 mg/L had 100% sensitivity, 60.5% specificity, 71.7% positive predictive value and 100% negative predictive value with an area under the curve of 0.80 (p=0.153). This results showed that while the CRP cut-off value of 36 mg/L can’t be used as a predictor of AL, it can be used as a predictor of non-AL, therefore, it can be used as a criterion for patient discharge.
Keywords: Anastomotic failure, bowel resection, CRP.