Predictive Value of C-Reactive Protein for Complications Post-Laparoscopic Roux-En-Y Gastric Bypass.
Laparoscopic roux-en-Y gastric bypass (LRYGB) has gained increasing popularity as the primary procedure of choice for the management of patients with morbid obesity. Despite the advances, a few patients will still develop complications and predicting these early complications in morbidly obese patients can prove to be difficult. Radiological investigations have limited diagnostic value and have associated side effects and cost. We propose that C-reactive protein (CRP) is a useful predictor for early postoperative complications. This study aims to determine the ability of CRP taken on postoperative day 1 (POD 1) and 2 to predict occurrence of complications within 30 days of surgery.



This retrospective observational study selected 183 consecutive patients from the York bariatric database between 01 December 2010 and 23 March 2015.



Patients undergoing dual procedures, conversion to open, and if no postoperative CRP measurement was performed.



In total, 138 patients satisfied the inclusion criteria during the study period (median age 44 years [20-68], BMI 50.6 kg/m2 [38.3-62.5]). Fifteen (10.8 %) patients had minor complications (CD of 2) and 8 (5.6 %) had major complications (CD 3 or above). A CRP of greater than 127 mg/L on POD 2 was found to predict complications with 93 % sensitivity and 64 % specificity with diagnostic accuracy 0.82 (95 % confidence interval 0.731-0.908).



In our patients, CRP on POD 2 has been shown to be a good predictor of both minor and major complications and can therefore be used to guide clinicians in making decision as to which patients may need further investigation or who can be safely discharged.
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK. murray.williams@york.nhs.uk.
Murray R
MR
Williams
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Samuel
S
McMeekin
Department of Anaesthetics, York Teaching Hospitals NHS Trust, York, UK.
R Jonathan T
RJ
Wilson
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Glenn V
GV
Miller
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Fiona E
FE
Langlands
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Wingzou
W
Wong
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Mark
M
Peter
Department of Surgery, York Teaching Hospitals NHS Trust, York, UK.
Mathew S
MS
Giles
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000175:diagnosis; D055815:Young Adult
D015415:Biomarkers; D002097:C-Reactive Protein
Bariatric surgery; C-reactive protein; CRP; Laparoscopic roux-en Y gastric bypass; Postoperative complications; ROC curve analysis
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