Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Ge, Xiaolong; Cao, Yu; Wang, Hongkan; Ding, Chao; Tian, Hongliang; Zhang, Xueying; Gong, Jianfeng; Zhu, Weiming; Li, Ning
• Is Part Of: World journal of surgical oncology. Volume 15:Issue 1(2017)
• Page Start: 1
• Page End: 7
• Publication Date: 2017-12
• Subjects: C-reactive protein to albumin ratio -- Colorectal surgery -- Diagnoses; Cancer -- Surgery -- Periodicals; Tumors -- Periodicals; Tumors -- Surgery -- Periodicals; Surgery, Operative -- Periodicals; 616.994059
• DOI: 10.1186/s12957-016-1092-1
• Languages: English
• ISSNs: 1477-7819

Abstract

Abstract Background The ratio of C-reactive protein to albumin, as a novel inflammation-based prognostic score, is associated with outcomes in cancer and septic patients. The diagnostic accuracy of the CRP/albumin ratio has not been assessed in colorectal surgery for postoperative complications. Methods A total of 359 patients undergoing major colorectal surgery between 2012 and 2015 were eligible for this study. Uni- and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and diagnostic accuracy of the CRP/albumin ratio and postoperative CRP levels. Results Among all the patients, 139 (38.7%) were reported to have postoperative complications. The CRP/albumin ratio was an independent risk factor for complications (OR 4.413; 95% CI 2.463–7.906;P < 0.001), and the cutoff value was 2.2, which had a higher area under the curve compared to CRP on postoperative day 3 (AUC 0.779 vs 0.756). The CRP/albumin ratio also had a higher positive predictive value than CRP levels on postoperative day 3. Patients with CRP/albumin ≥2.2 suffered more postoperative complications (60.8% vs 18.6%, P < 0.001), longer postoperative stays (10 (4–71) vs 7 (3–78) days, P < 0.001), and increased surgical site infections (SSIs) (21.1% vs 4.8%, P < 0.001) than those with CRP/albumin <2.2. Conclusions The ratio of C-reactive protein to albumin could help to identify patients who have a high probability of postoperative complications, and the ratio has higher diagnostic accuracy than C-reactive protein alone for postoperative complications in colorectal surgery.