Rohit Gohil1, Majed Rishi1, Benjamin H L Tan2. 1. Department of General Surgery, Pilgrim Hospital, Sibsey Rd, Boston, Lincolnshire PE21 9QS. U.K. 2. Department of General Surgery, Pilgrim Hospital, Sibsey Rd, Boston, Lincolnshire PE21 9QS. U.K ; Division of Gastrointestinal Surgery, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, NG7 2UH. U.K.
Abstract
AIMS: Colorectal cancer is the third most common cancer in European populations. It has been shown previously that neutrophil-lymphocyte ratio (NLR), pre-operative albumin, and haemoglobin are useful prognostic indicators. The aim of this study was to assess how these factors influence the length of postoperative stay (LOS) following colorectal cancer surgery. METHODOLOGY: All patients undergoing elective colorectal resections for malignancy between 2010 and 2011 in Pilgrim Hospital, Boston, U.K. were considered for the study. Hospital archive systems were used to ascertain pre-operative NLR, albumin and haemoglobin levels. LOS was calculated from electronic discharge documents with day 1 being the day after surgery. Unifactorial and multifactorial analyses were performed to identify independent predictors of prolonged stay. RESULTS: 196 patients were included in the study. Pre-operative haemoglobin was not associated with prolonged hospital stay. On univariate analysis, pre-operative serum albumin and pre-operative NLR were associated with prolonged hospital stay. On multivariate analysis, pre-operative serum albumin >34.5 g/dl (odds ratio, 0.47; 95% confidence interval, 0.24 - 0.92; p = 0.027) retained independent association for prolonged hospital stay .However, pre-operative NLR failed to reach statistical significance on multivariate analysis. CONCLUSIONS: Patients with low albumin and elevated NLR are more likely to have an increased hospital stay following colorectal cancer surgery. This may be useful for surgeons in terms of identifying the 'high-risk' patient post-operatively and allow for early intervention.
AIMS: Colorectal cancer is the third most common cancer in European populations. It has been shown previously that neutrophil-lymphocyte ratio (NLR), pre-operative albumin, and haemoglobin are useful prognostic indicators. The aim of this study was to assess how these factors influence the length of postoperative stay (LOS) following colorectal cancer surgery. METHODOLOGY: All patients undergoing elective colorectal resections for malignancy between 2010 and 2011 in Pilgrim Hospital, Boston, U.K. were considered for the study. Hospital archive systems were used to ascertain pre-operative NLR, albumin and haemoglobin levels. LOS was calculated from electronic discharge documents with day 1 being the day after surgery. Unifactorial and multifactorial analyses were performed to identify independent predictors of prolonged stay. RESULTS: 196 patients were included in the study. Pre-operative haemoglobin was not associated with prolonged hospital stay. On univariate analysis, pre-operative serum albumin and pre-operative NLR were associated with prolonged hospital stay. On multivariate analysis, pre-operative serum albumin >34.5 g/dl (odds ratio, 0.47; 95% confidence interval, 0.24 - 0.92; p = 0.027) retained independent association for prolonged hospital stay .However, pre-operative NLR failed to reach statistical significance on multivariate analysis. CONCLUSIONS: Patients with low albumin and elevated NLR are more likely to have an increased hospital stay following colorectal cancer surgery. This may be useful for surgeons in terms of identifying the 'high-risk' patient post-operatively and allow for early intervention.
Entities:
Keywords:
Colorectal cancer; length of post-operative stay; neutrophil-lymphocyte ratio; serum albumin
Authors: Cornelis P C de Jager; Peter C Wever; Eugenie F A Gemen; Ron Kusters; Arianne B van Gageldonk-Lafeber; Tom van der Poll; Robert J F Laheij Journal: PLoS One Date: 2012-10-01 Impact factor: 3.240
Authors: Martin Bailon-Cuadrado; Baltasar Perez-Saborido; Javier Sanchez-Gonzalez; Mario Rodriguez-Lopez; Agustin Mayo-Iscar; David Pacheco-Sanchez Journal: Int J Colorectal Dis Date: 2018-06-20 Impact factor: 2.571