title: Predictive value of preoperative serum C-reactive protein for recurrence after definitive surgical repair of enterocutaneous fistula.
abstract: BACKGROUND
  Recurrence rates after surgical repair of enterocutaneous fistula (ECF) have not changed substantially. Serum C-reactive protein (s-CRP) has been used as an indicator of postoperative complications in abdominal surgery. ​ The aim of this study was to determine the predictive value of preoperative s-CRP for recurrence after definitive surgical repair of ECF.
  
  
  METHODS
  Fifty consecutive patients with ECF persistence submitted electively to definitive surgical repair (ECF resection with primary anastomosis) were included. Among several variables, preoperative s-CRP (primary independent variable) was assessed as a factor related to recurrence (dependent variable). Univariate and multivariate analyses were performed.
  
  
  RESULTS
  ECF recurred in 19 patients (38%). Univariate and multivariate analyses disclosed operative blood loss greater than 325 mL (P < .05) and preoperative s-CRP greater than .5 mg/dL (P < .01) as the only risk factors for recurrence. ECF recurrence rates were significantly higher for patients with preoperative s-CRP above this level (53% vs 11%, P < .01). After conservative and surgical management, overall ECF closure was attained in 40 patients (80%).
  
  
  CONCLUSIONS
  Our results suggest that s-CRP may serve as a useful parameter to predict potential failure (recurrence) in patients submitted to definitive closure of ECF.
authors.affiliation: Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México. Electronic address: jlmo1968@yahoo.com.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Martinez
authors.affiliation: Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México.
authors.forename: Enrique
authors.initials: E
authors.lastname: Luque-de-León
authors.affiliation: Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ferat-Osorio
authors.affiliation: Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México.
authors.forename: Alicia
authors.initials: A
authors.lastname: Estrada-Castellanos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000097:blood* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; Enteroatmospheric fistula; Enterocutaneous fistula; Intestinal fistula; Intestinal fistula surgery; Surgical complications