C-Reactive protein to albumin ratio to predict postoperative complications after gastrectomy for gastric cancer
Seref Dokcu, Mehmet Ali Caparlar
The aim of the study was to evaluate the availability of C-reactive protein / albumin ratio (CRP/ALB) in the prediction of postoperative complications after gastrectomy for gastric cancer. The primary outcome measure was to find out whether an association exists between postoperative major complications and common predictive measures. The secondary outcome measures were to compare predictive measures in patients with or without major complications. After obtaining hospital’s ethic committee approval medical data were obtained using electronic medical database and medical files of patients who underwent resection surgery for gastric cancer between 2015 and 2020. The inclusion criteria were adult patients and elective primary surgery. Patients with metastatic gastric cancer, urgent surgery, liver cirrhosis, previous infection, lost to follow-up, and insufficient data were excluded. Of 200 patients who were included in the study, 18 patients had major postoperative complications including anastomotic leakage in 7 (3.5%) patients, intestinal obstruction in 5 (2.5%) patients, intraabdominal abscess in 5 (2.5%) patients, pleural effusion in 1 (0.5%) patient. As a result of univariate and multivariate analysis, elevated CAR (OR 3.73; 95% CI 2.02-8.13; p=0.01) and CRP levels (OR 2.82; 95% CI 1.34-7.61; p=0.02) at postoperative 3. days were found as independent predictors for major complications. The patients with major complications were admitted more likely to intensive care unit (77.8% vs. 30.7%; p=0.017) and mean discharge time was longer (16.7±4.9 days vs. 7.9±2.4; p=0.021). CRP to ALB ratio and CRP levels at the postoperative 3. day were found to be independent predictors of major complications after gastrectomy for gastric cancer.
Key words: Albumin, complication, C-reactive protein, gastrectomy, gastric cancer