C-reactive protein is superior to white blood cell count for early detection of complications after pancreatoduodenectomy: a retrospective multicenter cohort study.
HPB (Oxford)
; 22(10): 1504-1512, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32171648
ABSTRACT
BACKGROUND:
Early detection of major complications after pancreatoduodenectomy could improve patient management and decrease the "failure-to-rescue" rate. In this retrospective cohort study, we aimed to compare the value of C-reactive protein (CRP) and white blood cell count (WBC) in the early detection of complications after pancreatoduodenectomy.METHODS:
We assessed pancreatoduodenectomies between January 2012 and December 2017. Major complications were defined as grade III or higher according to the Clavien-Dindo classification. Postoperative pancreatic fistula (POPF) was a secondary endpoint. ROC-curve and logistic regression analysis were performed for CRP and WBC. Results were validated in an external cohort.RESULTS:
In the development cohort (n = 285), 103 (36.1%) patients experienced a major complication. CRP was superior to WBC in detecting major complications on postoperative day (POD) 3 (AUC0.74 vs. 0.54, P < 0.001) and POD 5 (AUC0.77 vs. 0.68, P = 0.031), however not on POD 7 (AUC0.77 vs. 0.76, P = 0.773). These results were confirmed in multivariable analysis and in the validation cohort (n = 202). CRP was also superior to WBC in detecting POPF on POD 3 (AUC 0.78 vs. 0.54, P < 0.001) and POD 5 (AUC 0.83 vs. 0.71, P < 0.001).CONCLUSION:
CRP appears to be superior to WBC in the early detection of major complications and POPF after pancreatoduodenectomy.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteína C-Reativa
/
Pancreaticoduodenectomia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
HPB (Oxford)
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article