Procalcitonin and CRP as Predictors of Anastomotic Dehiscence in Adult Patients.

Introduction Intestinal anastomotic leakage is a serious postoperative complication associated with high morbidity and mortality. Although acute-phase reactants such as procalcitonin (PCT) and CRP have been proposed as early biomarkers, their predictive utility remains insufficiently established in low-resource settings. This study aimed to evaluate the usefulness of PCT and CRP in detecting anastomotic leakage in adult patients undergoing intestinal surgery at a secondary-level hospital. Methods A retrospective, cross-sectional, and analytical case series was conducted based on the medical records of adult patients who underwent intestinal anastomosis between July 2022 and July 2024 at a secondary-level public hospital in Mexico. Thirty patients met the inclusion criteria. Serum levels of PCT and CRP were measured on postoperative days 1, 3, and 5. Descriptive and inferential statistical analyses were performed. The Holm-Bonferroni method was applied to adjust for multiple comparisons. A p-value < 0.05 was considered statistically significant. Results Five patients (16.7%) developed anastomotic leakage. On postoperative day five, mean PCT levels were significantly higher in patients with leakage (9.02 ± 15.92 ng/mL) compared to those without leakage (2.63 ± 1.52 ng/mL; unadjusted p = 0.044), although this difference lost significance after adjustment for multiple comparisons. CRP levels followed a similar upward trend in the leakage group (288.45 ± 223.67 mg/L vs. 186.41 ± 74.83 mg/L; p = 0.067), but the difference was not statistically significant. Leakage occurred more frequently in colorectal anastomoses and was associated with longer hospital stays, higher reoperation rates, and increased mortality, though none of these associations reached statistical significance. Conclusion Serial measurement of PCT, and to a lesser extent, CRP, may support the early detection of anastomotic leakage after intestinal surgery. However, given the small sample size and loss of statistical significance after correction, these findings should be interpreted with caution. Larger prospective studies are needed to validate these preliminary observations and determine their clinical applicability in broader surgical settings.