Hangfen Zhao1, Huaying Liu2, Weilin Qi1, Wei Liu1, Lingna Ye3, Qian Cao3, Xiaolong Ge1, Wei Zhou1, Xianfa Wang1. 1. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China. 2. Department of Medicine, Guangxi Medical College, Nanning 530000, China. 3. Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
Abstract
BACKGROUND: The ratio of C-reactive protein (CRP) to albumin (CAR) has a significant correlation with postoperative complications and acts as a predictor in patients with pancreatic cancer and colorectal cancer. However, whether the CAR can be used to predict complications in Crohn's disease (CD) patients after surgery has not yet been reported. METHODS: A total of 534 CD patients undergoing surgery between 2016 and 2020 were enrolled. The risk factors of postoperative complications were assessed by univariate and multivariate analyses. The cutoff values and the accuracy of diagnosis for the CAR and postoperative CRP levels were examined with receiver operating characteristic (ROC) curves. RESULTS: The rate of postoperative complications was 32.2%. The postoperative CAR (OR 13.200; 95% CI 6.501-26.803; P < 0.001) was a significant independent risk factor for complications. Compared with the CRP level on postoperative day 3, the CAR more accurately indicated postoperative complications in CD patients (AUC: 0.699 vs. 0.771; Youden index: 0.361 vs. 0.599). ROC curves showed that the cutoff value for the CAR was 3.25. Patients with a CAR ≥ 3.25 had more complications (P < 0.001), a longer postoperative stay (15.5 ± 0.6 d vs. 9.0 ± 0.2 d, P < 0.001), and more surgical site infections (48.2% vs. 5.7%, P < 0.001) than those with a CAR < 3.25. CONCLUSIONS: Compared to the CRP level, the CAR can more accurately predict postoperative complications and can act as a predictive marker in CD patients after surgery.
BACKGROUND: The ratio of C-reactive protein (CRP) to albumin (CAR) has a significant correlation with postoperative complications and acts as a predictor in patients with pancreatic cancer and colorectal cancer. However, whether the CAR can be used to predict complications in Crohn's disease (CD) patients after surgery has not yet been reported. METHODS: A total of 534 CD patients undergoing surgery between 2016 and 2020 were enrolled. The risk factors of postoperative complications were assessed by univariate and multivariate analyses. The cutoff values and the accuracy of diagnosis for the CAR and postoperative CRP levels were examined with receiver operating characteristic (ROC) curves. RESULTS: The rate of postoperative complications was 32.2%. The postoperative CAR (OR 13.200; 95% CI 6.501-26.803; P < 0.001) was a significant independent risk factor for complications. Compared with the CRP level on postoperative day 3, the CAR more accurately indicated postoperative complications in CD patients (AUC: 0.699 vs. 0.771; Youden index: 0.361 vs. 0.599). ROC curves showed that the cutoff value for the CAR was 3.25. Patients with a CAR ≥ 3.25 had more complications (P < 0.001), a longer postoperative stay (15.5 ± 0.6 d vs. 9.0 ± 0.2 d, P < 0.001), and more surgical site infections (48.2% vs. 5.7%, P < 0.001) than those with a CAR < 3.25. CONCLUSIONS: Compared to the CRP level, the CAR can more accurately predict postoperative complications and can act as a predictive marker in CD patients after surgery.
Authors: Jonathan J Platt; Michelle L Ramanathan; Robin A Crosbie; John H Anderson; Ruth F McKee; Paul G Horgan; Donald C McMillan Journal: Ann Surg Oncol Date: 2012-07-18 Impact factor: 5.344
Authors: Fernando Gomollón; Axel Dignass; Vito Annese; Herbert Tilg; Gert Van Assche; James O Lindsay; Laurent Peyrin-Biroulet; Garret J Cullen; Marco Daperno; Torsten Kucharzik; Florian Rieder; Sven Almer; Alessandro Armuzzi; Marcus Harbord; Jost Langhorst; Miquel Sans; Yehuda Chowers; Gionata Fiorino; Pascal Juillerat; Gerassimos J Mantzaris; Fernando Rizzello; Stephan Vavricka; Paolo Gionchetti Journal: J Crohns Colitis Date: 2016-09-22 Impact factor: 9.071