Neutrophil to lymphocyte ratio and C-reactive protein as predictive tools of anastomotic leakage following gastro intestinal surgery

Abstract

Aim: To assess the prognostic value of postoperative CRP and NLR in patients who develop anastomotic leak (AL) following GI surgery. Methodology: A prospective study carried out for 15 months in ESIC medical college and hospital. All patients above 18 years who underwent gastrointestinal surgery involving anastomosis (both hand sewn and stapled techniques) irrespective of site of anastomosis were considered for the study. Results: Out of 46 cases studied, 8 cases had anastomotic leakage. Combined NLR and C-RP has sensitivity of 90% and negative predictive value of 98.6% which helps in determining the occurrence of anastomotic leakage in post-op patients. Conclusion: CRP and NLR on POD4 possess the ability to predict the development of AL. Based on our results, high NPV is indicative of patients with low risk of AL in their postoperative period.