Aims-Colorectal cancer is the third most common cancer in European populations. It has been shown previously that neutrophil-lymphocyte ratio (NLR), pre-operative albumin, and haemoglobin are useful prognostic indicators. The aim of this study was to assess how these factors influence the length of postoperative stay (LOS) following colorectal cancer surgery.Methodology-All patients undergoing elective colorectal resections for malignancy between 2010 and 2011 in Pilgrim Hospital, Boston, U.K. were considered for the study. Hospital archive systems were used to ascertain pre-operative NLR, albumin and haemoglobin levels. LOS was calculated from electronic discharge documents with day 1 being the day after surgery. Unifactorial and multifactorial analyses were performed to identify independent predictors of prolonged stay Results-196 patients were included in the study. Pre-operative haemoglobin was not associated with prolonged hospital stay. On univariate analysis, pre-operative serum albumin and preoperative NLR were associated with prolonged hospital stay. On multivariate analysis, preoperative serum albumin >34.5 g/dl (odds ratio, 0.47; 95% confidence interval, 0.24 -0.92; p = 0.027) retained independent association for prolonged hospital stay .However, pre-operative NLR failed to reach statistical significance on multivariate analysis.Conclusions-Patients with low albumin and elevated NLR are more likely to have an increased hospital stay following colorectal cancer surgery. This may be useful for surgeons in terms of identifying the 'high-risk' patient post-operatively and allow for early intervention. *Corresponding author: benjamintan@hotmail.co.uk. AUTHORS' CONTRIBUTIONSBT designed the study and performed the statistical analysis. RG collected the data, managed the analyses of the study and wrote the first draft of the manuscript. MR collected the data, managed the analyses of the study. All authors read and approved the final manuscript. COMPETING INTERESTSAuthors have declared that no competing interests exist. Europe PMC Funders Group

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