Background and Objectives: Anastomotic Leakage (AL) remains a significant complication after elective gastrointestinal (GI) surgery, with a lack of reliable predictors. Aims: This study aimed to identify a quantifiable predictor of AL and test the predictive accuracy of established markers. Methods: A descriptive longitudinal study was conducted on 50 consenting patients aged 18-75 years who underwent elective GI surgery in the General Surgery Department at NRS Medical College and Hospital, Kolkata, from November 2022 to April 2024. Ethical clearance was obtained from the Institutional Ethics Committee. Preoperative interviews were conducted using a predesigned questionnaire. Laboratory investigations were performed using standard procedures at the same hospital. The operation time and intraoperative blood loss were noted. Statistical analysis for predictive accuracy was performed using SPSS v. 20. Results: Among the studied patients, 26% experienced postoperative anastomotic leakage. Age, body mass index (BMI), and preoperative total leucocyte count were not significantly different across the groups. C-reactive protein (CRP) levels were higher, and serum albumin levels were lower in patients with leaks. CRP-to- Albumin Ratio (CAR) and intraoperative blood loss were significantly higher in patients with a leak. CARBB, calculated as CRP (g/dl) × BMI (kg/m 2 ) times blood loss (ml) divided by serum albumin (g/dl), was found to be significantly higher in patients with a leak with the highest area under the receiver operating characteristic curve (0.798) and significant predictive ability ( P = 0.002) for anastomotic leak compared to other predictors. Conclusion: This study provides evidence supporting the use of CARBB as a novel, robust predictor of AL following elective GI surgery.
Chowdhury et al. (Thu,) studied this question.