Background. This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis. Methods. A total of 246 eligible patients who were scheduled to undergo surgical treatment for peritonitis-induced sepsis were enrolled in this study. The primary observational endpoint was 28-day hospital mortality. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were carried out to evaluate the association of baseline AFR and prognosis in septic patients. Results. Of all the cohort study participants, there were 59 nonsurvivors with a 28-day mortality of 24.0% (59/246). Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42–0.93, P=0.018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42–3.91, P=0.021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. Baseline AFR was a significant predictor for 28-day mortality with an area under the curve (AUC) of 0.751, a cut-off value of 8.85, a sensitivity of 66.10%, and a specificity of 70.05%, respectively (95% CI: 0.688–0.813, P<0.001). A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with log-rank test (P=0.004). Conclusions. This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis.

Background Postoperative delirium (POD) is a very common complication in operative disciplines, especially in those elderly patients after cardiac surgery. This study aimed to investigate the relationship between C-reactive protein (CRP) and POD in elderly patients undergoing laparoscopic surgery for colon carcinoma. Methods 160 elderly patients scheduled to undergo selective laparoscopic surgery for colon carcinoma were prospectively recruited in this present study. The preoperative demographic and medical characteristics, intraoperative variables, and postoperative complications were all recorded in detail. POD assessment was performed once a day for the first 3 days and at 7th day after surgery, respectively. CRP concentrations preoperatively and on postoperative days 1, 2, and 3 were measured by using human enzyme linked immunosorbent assay (ELISA). Results Of all the 160 enrolled patients, 39 had suffered POD with a POD incidence of 24.4% within the first week after the operation. The univariate analysis and multiple logistic regression analysis suggested preoperative CRP concentrations as the only independent predicator for POD in patients undergoing laparoscopic surgery for colon carcinoma (OR: 5.87; 95% CI: 2.22–11.4; P = 0.018). Conclusions This present study highlighted the predictive role of preoperative CRP concentrations for POD in elderly patients undergoing laparoscopic surgery for colon carcinoma.

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