Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection

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) pa...

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Main Authors: Hangfen Zhao, Huaying Liu, Weilin Qi, Wei Liu, Lingna Ye, Qian Cao, Xiaolong Ge, Wei Zhou, Xianfa Wang
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2021/6629608
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author Hangfen Zhao
Huaying Liu
Weilin Qi
Wei Liu
Lingna Ye
Qian Cao
Xiaolong Ge
Wei Zhou
Xianfa Wang
author_facet Hangfen Zhao
Huaying Liu
Weilin Qi
Wei Liu
Lingna Ye
Qian Cao
Xiaolong Ge
Wei Zhou
Xianfa Wang
author_sort Hangfen Zhao
collection DOAJ
description 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.
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spelling doaj-art-337edecd3970468c8eebe0107e607a592025-02-03T01:29:19ZengWileyGastroenterology Research and Practice1687-61211687-630X2021-01-01202110.1155/2021/66296086629608Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel ResectionHangfen Zhao0Huaying Liu1Weilin Qi2Wei Liu3Lingna Ye4Qian Cao5Xiaolong Ge6Wei Zhou7Xianfa Wang8Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of Medicine, Guangxi Medical College, Nanning 530000, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, ChinaBackground. 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.http://dx.doi.org/10.1155/2021/6629608
spellingShingle Hangfen Zhao
Huaying Liu
Weilin Qi
Wei Liu
Lingna Ye
Qian Cao
Xiaolong Ge
Wei Zhou
Xianfa Wang
Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
Gastroenterology Research and Practice
title Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
title_full Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
title_fullStr Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
title_full_unstemmed Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
title_short Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection
title_sort postoperative ratio of c reactive protein to albumin as a predictive marker in patients with crohn s disease undergoing bowel resection
url http://dx.doi.org/10.1155/2021/6629608
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