Biochemical indicators of in-hospital complications following pancreatic surgery.
Early recognition of complications following pancreatic surgery could reduce morbidity and mortality. White cell counts (WCCs), platelets (PLTs), C-reactive protein (CRP) and albumin (ALB) are commonly used as guides in clinical decision making. However, the evidence to support their role as early indicators of complications is unclear. A retrospective cohort analysis of consecutive pancreatic surgical procedures between 2004 and 2008 was performed. Operative procedures, inflammatory markers--WCCs, PLTs, CRP, and ALB--preoperatively and on postoperative days (PODs) 1, 3, 5, 7, 9, 12, and 15, and clinical outcomes were recorded. WCC > 11 x 10(9)/L on POD5 was significantly associated with complications [odds ratio (OR), 2.60; P = 0.0067]. ALB < 28 g/L on POD7 was significantly associated with a postoperative complication (OR, 2.94; P = 0.0031). WCC > 12.2 x 10(9)/L and ALB < or = 28 g/L on POD7 were more likely to be associated with a complication (OR, 4.86; P = 0.0002). Postoperative WCC and ALB levels may be useful as aids to the early diagnosis of complications following pancreatic surgery.
Centre for HPB and Liver Transplantation, Royal Free Hospital and University College School of Medicine, Royal Free Hospital, London, United Kingdom. bjosephje@gmail.com
Biku J
BJ
John
Sanjay
S
Wijeyekoon
Nienke
N
Warnaar
Prasoona
P
Shasi
Sakirullah H
SH
Rahman
B R
BR
Davidson
G
G
Fusai
D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D010180:Pancreatectomy / Q000009:adverse effects*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010976:Platelet Count; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D012372:ROC Curve; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D013156:Splenectomy
D012709:Serum Albumin; D002097:C-Reactive Protein