Marie Ashley Villard, BA, Melissa C Helm, BS, Tammy L Kindel, MD, PhD, Matthew I Goldblatt, MD, Jon C Gould, MD, Rana M Higgins, MD. Medical College of Wisconsin
Introduction: The primary objective of this study was to evaluate the utility of CRP in early identification of post-operative complications after bariatric surgery. The ability of this marker to acutely predict post-operative complications in bariatric surgery patients has not been determined.
Methods: A retrospective chart review was conducted of adult patients who underwent a primary and revisional laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (LSG) between 2013 and 2017 at a single institution. Patients were identified using the prospective Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. CRP levels were drawn on post-operative day one per standard protocol. Univariate analyses were performed to determine the predictive impact of CRP levels on post-operative complications, readmissions, and reoperations.
Results: There were 275 patients who underwent bariatric surgery, 222 primary and 53 revisional. Of the 275 patients, 33 (12.0%) had a complication. Patients with a 30-day post-operative complication had higher CRP levels compared to those who did not (5.1 ± 4.7 mg/dL vs 2.9 ± 2.0 mg/dL; p = 0.02) (Table 1). A CRP≥ 5 mg/dL had a sensitivity for a complication of 27% and a specificity of 88%. Primary bariatric surgery patients with a post-operative complication had higher CRP levels compared to those who did not (4.9 ± 4.9 mg/dL vs 2.8 ± 1.9 mg/dL; p = 0.008). There was no difference in CRP levels for patients with a 30-day reoperation or readmission. There were no mortalities.
Conclusions: Bariatric surgery patients with elevated post-operative CRP levels are at increased risk for 30-day complications. The low sensitivity of a CRP≥ 5 mg/dL suggests that a normal CRP level alone does not rule out the possibility of a post-operative complication. However, with its high specificity, there should be an elevated clinical suspicion of a post-operative complication in patients with a CRP≥ 5 mg/dL.
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Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87019
Program Number: P667
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster