Utility of base deficit, lactic acid, microalbuminuria, and C-reactive protein in the early detection of complications in the immediate postoperative evolution

Objective: To determine the utility of biochemical parameters such as lactic acid (LA), C-reactive protein (CRP), microalbuminuria (MAU), and base deficit (BD) as early markers of complications in the immediate postoperative evolution of elective open gastrointestinal surgeries. Design and Methods: Sixty-two patients subject to elective open gastrointestinal surgery were evaluated during a period of 22 months. Results: From the initial 62 patients, 2 were excluded, 29 (48.3%) evolved without complications, and 31 (51.6%) with complications. It was observed that the most significant areas under the ROC curve corresponded to BD in the preoperative period, LA on the first day, and CRP from the second to the seventh day after surgery. MAU was not a discriminating parameter since it did not reach a significant area under the curve (AUC) at any time. Conclusions: The biochemical markers that best relate to the presence of complications are BD in the preoperative period, LA on the first day, and CRP from the second to the seventh day after surgery. (C) 2004 The Canadian Society of Clinical Chemists. All rights reserved.