anastomoticleak.com
The ANACO study group reported the results of a prospective cohort study of patients undergoing colorectal (right and left sided) resection in 2011-12 in the Annals of Surgery.
Related paper: Risk Factors for Anastomotic Leak After Colon Resection for Cancer
In total data was collected on 3,193 patients across 52 Spanish hospitals. The overall anastomotic leak rate was 8.7%. Patients who experienced anastomotic leak experienced a much higher mortality than patients who did not have a leak (15.2% versus 1.9%).
The group created a risk stratifier to predict the risk of anastomotic leak. This included:
- Use of oral anticoagulants (excluding aspirin)
- Obesity (body mass index >30)
- Total serum protein
- Sex
- Intra-operative complication
- Total number of hospital beds
The risk stratifier has been externally validated by an Sammour and colleagues in Australia, who found that in a prospective cohort of 83 patients anastomoticleak.com was highly predictive of leak (area under the curve [AUC] 0.84). In contrast surgeons’ predictions were worse than guessing (AUC 0.40)!