A multicentre cohort study of serum and peritoneal biomarkers to predict anastomotic leakage after rectal cancer resection
This model predicts the individual risk for anastomotic leakage after rectal resection with systemic CRP and peritoneal MMP9 levels on postoperative day 3

(c-index = 0.78)
Research authors: C.L. Sparreboom, N. Komen, D. Rizopoulos, A.P. Verhaar, W.A. Dik, Z. Wu , H.L. van Westreenen, P.G. Doornebosch, J.W.T. Dekker, A.G. Menon, F. Daams, D. Lips, W.M.U. van Grevenstein, T.M. Karsten, Y. Bayon, M.P. Peppelenbosch, A.M. Wolthuis, A. D'Hoore, J.F. Lange
Details Formula Study characteristics Files & References
Model author
Model ID
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MeSH terms
  • Colorectal Surgery
  • Anastomotic Leakage
  • Model type
    Logistic regression (Calculation)
    No Formula defined yet
    Condition Formula

    Additional information

    Study design
    This study was designed as an international prospective multicenter cohort study. All patients gave written informed consent. The follow-up ended at the first outpatient clinic visit after hospital discharge.

    Study population
    Patients aged 18 years and older who underwent partial mesorectal excision (PME) or total mesorectal excision (TME) with construction of a colorectal anastomosis were eligible for inclusion. We excluded pregnant women and patients who underwent an emergency procedure. In addition, patients of whom no drain fluid was obtained or who underwent surgery for another indication than adenocarcinoma were excluded. All patients gave written informed consent.

    Drain fluid collection and analysis 
    All patients received a pelvic drain during surgery. Drain fluid was collected every morning on the first three postoperative days. The samples were stored in a -80°C fridge and analyzed for biomarkers in badge. 

    Study Population

    Total population size: 292
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Anastomotic Leakage Yes 38
    No 254

    Related files

    No related files available

    The risk of anastomotic leakage after rectal resection

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    The risk of anastomotic leakage after rectal resection

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    Outcome stratification

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    Result interpretation

    This prospective multicenter cohort study provides a prediction model for anastomotic leakage after rectal resection including CRP and MMP9 on postoperative day 3. This nomogram calculates the individual risk for anastomotic leakage after rectal resection. Assessment of model discrimination yielded a concordance index of 0.78. In addition, this model obtained good calibration with a mean absolute error of 0.025. 

    This tool should never replace clinical observations and should be interpreted in clinical context as with any other diagnostic tool.

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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