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Int J Surg ; 27: 92-98, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26827891

ABSTRACT

BACKGROUND: We have obtained a diagnostic score (DIACOLE) in order to detect anastomotic leakage in the postoperative period of colorectal cancer surgery. METHODS: Systematic review to identify any symptoms and clinical or analytical signs associated with anastomotic leakage after colorectal cancer surgery and a meta-analysis of each of these factors. The DIACOLE score encompasses all factors that reached statistical significance in their respective meta-analyses. The value of each factor in the score was determined depending the Napierian logarithm of the odds ratios. The index was validated using collected data at our institution. RESULTS: We identified 13 potential signs and symptoms of anastomotic leakage to elaborate the DIACOLE score. The predictive power of the DIACOLE was validated in a case-control study, resulting in an Area Under Curve (AUC) of 0.911 and a 95% confidence interval. These values were considered indicative of a very good diagnostic score. CONCLUSIONS: If DIACOLE score is > 3.065, a blood count and re-evaluating the score daily are recommended. If the DIACOLE>5.436, a radiological test is advised. We have developed free software to obtain DIACOLE value.


Subject(s)
Anastomotic Leak/diagnosis , Colectomy/adverse effects , Colorectal Neoplasms/surgery , Health Status Indicators , Anastomotic Leak/blood , Area Under Curve , Case-Control Studies , Colorectal Neoplasms/blood , Humans , Odds Ratio , Postoperative Period , Predictive Value of Tests , Retrospective Studies
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