Evidence map›Paper›PMID 35055369›Full record

ArticleJournal of personalized medicine2022

Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn's Disease Patients.

Moran Slavin, Avigayil Goldstein, Barak Raguan, Yaron Rudnicki, Shmuel Avital, Ian White

Open access · goldAbstract read
In one paragraph

Article in Journal of personalized medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Moran SlavinDepartment of Surgery, Meir Medical Center, Kfar Saba 4428164, Israel.ORCID 0000-0002-0500-7143
Avigayil GoldsteinSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Barak RaguanDepartment of Surgery, Meir Medical Center, Kfar Saba 4428164, Israel.
Yaron RudnickiDepartment of Surgery, Meir Medical Center, Kfar Saba 4428164, Israel.
Shmuel AvitalDepartment of Surgery, Meir Medical Center, Kfar Saba 4428164, Israel.
Ian WhiteSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Tel Aviv University · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3-4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn's disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to determine whether postoperative CRP levels can be used to rule out anastomotic leaks in patients with Crohn's disease and to set CRP threshold values for this population.

methodsThis was a retrospective study of a population of Crohn's disease patients who underwent surgery with bowel anastomoses at a single high-volume center between 1/2012 and 12/2017. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist.

resultsNinety-two operations were performed. A CRP level of 19.56 mg/dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a negative predictive value (NPV) of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p = 0.06).

conclusionsMean CRP levels and CRP threshold values were indeed higher in the study population compared with those in colorectal cancer patients. Threshold values were set at 20.3 mg/dL on POD 3, 19.5 mg/dL on POD 4 and 16.7 mg/dL on POD 5. These values had high NPVs and can be used to rule out anastomotic leaks in patients with Crohn's disease after surgery with bowel anastomosis.

Indexed as

anastomotic leakCrohn’s diseaseNPVpostoperative CRP

Identifiers

PMID35055369
PMCPMC8780083
OpenAlexW4206678386

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.