EP693 - Blood Indices as Predictors of Anastomotic Leak after Colorectal Surgery – Is It Useful? A Retrospective Analysis.

Sunday, May 10, 2026

4:11 PM - 4:16 PM ET

ePoster Presenter(s)

aS

adbulaziz Saleem, n/a

associate professor,
associate professor, department of surgery, faculty of medicine, king abdulaziz university, jeddah, saudi arabia
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.

View ePoster

Author(s)

ge

ghada enani, MBBS, FRCSC

assistant professor of surgery
King abdulaziz university
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
mk

mai kadi, MBBS

Associate professor, community medicine
king abdulaziz university
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
AF

Ali Farsi, n/a

associate professor
associate professor, department of surgery, faculty of medicine, king abdulaziz university, jeddah, saudi arabia
Jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
AA

Abdullah Alshareef, MBBS

resident
king fahad hopsital
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
aa

abdulla alghamdi, MBBS

resident
king abdulaziz university
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
aa

ahmed alsaggaf, MBBS

ebbs
King abdulaziz hospital -ministry of health
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
ma

munasar alamoodi, MBBS

consultant
king abdulaziz university
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.
ma

muhannad alabbasi, MBBS

ER resident
Allieth general hospital
jeddah, Makkah, Saudi Arabia

Disclosure information not submitted.

Purpose/Background: The role of blood indices in predicting anastomotic leak (AL) after colorectal procedures is still lacking. Our aim is to assess if AL can be predicted using blood indices from the daily blood work.

Methods/Interventions: this is a retrospective study that included 441 patients who underwent colorectal surgery procedure. Demographic and clinical characteristics including ASA score, and patient’s comorbidities were collected. Results of preoperative blood work, up to 7 days postoperatively were collected. Blood indices including white blood count, red blood cell distribution width (RDW), neutrophil-to-lymphocyte (NTL) ratio, lymphocyte-to-monocyte (LTM) ratio, derived neutrophil-to-lymphocyte (dNLR) ratio, and platelet-to-lymphocyte (PTL) ratios were collected. Comparison between the groups were done using student t-test. A Bonferroni correction method was used for multiple comparisons, and adjusted p-values were reported. Pearson's correlation method was employed to quantify the strength of the linear relationship between these two factors. To assess the ability to use blood indices to predict the likelihood of AL, the area under the curve (AUC) was calculated within each receiver operating characteristic (ROC) curve. Then, a threshold for optimum sensitivity and specificity was selected and reported.

Results/Outcomes: The mean age was 52 years. 283 (64.2%) patients underwent open surgery, 261 (59.2%) were males. Risk factors that were associated with AL included high American Society of Anaesthesiologists (ASA) score, diabetes mellitus, and open surgery. Preoperative elevation of both WBC count, and neutrophil counts, and low lymphocyte to monocyte ratio were significantly associated with patients with AL. Postoperatively, elevation of WBC and neutrophil count on days 4 through 7, and elevation of neutrophil to lymphocyte ratio on day 6 postoperatively were significantly associated with AL. Likewise, the mean dNLR ratio was significantly high from day 5th-day 7th in patients with AL. The other parameters, including red blood cell distribution width (RDW), lymphocyte-to-monocyte (LTM) ratio, and platelet-to-lymphocyte (PTL) ratio, remained uninfluenced by AL.

Conclusion/Discussion: Blood indices are affordable and cheap method to help with early detection of AL after colorectal surgery procedures.