Can the C-reactive protein-to-plasma albumin ratio be an alternative scoring to show mortality and morbidity in patients with colorectal cancer?

Abstract

BACKGROUND: This study aims to demonstrate the sensitivity and specificity of C-reactive protein to plasma albumin (CRP/ALB) ratio in predicting morbidity and mortality in patients operated for colorectal cancer followed up in the intensive care unit by comparing it with current scoring systems. METHODS: The data of patients who underwent surgery for colorectal cancer and hospitalized in the intensive care unit between 2015-2018 with available data were retrospectively analyzed in this study. The CRP/ALB ratio, the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) prepared for both gastrointestinal and colorectal surgery, and the Association of Coloproctology of Great Britain and Ireland (ACPGBI-CRC) scoring system prepared for colorectal patients, were compared to determine their success in predicting mortality and morbidity. RESULTS: A total of 119 patients were included in this study. Mortality was observed in nine patients and morbidity was observed in 38 patients. When compared with P-POSSUM, which is the only scoring system showing morbidity, the CRP/ALB ratio was found to have a high prediction accuracy. The C reactive protein to plasma albumin ratio values was found to have lower power than P-POSSUM, CR-POSSUM and ACPGBI-CRC. CONCLUSION: Although scoring systems are useful in predicting morbidity and mortality in colorectal patients, they are difficult to use in practice since they include many parameters. that the findings obtained in this study suggest that the CRP/ALB ratio, which can be calculated without any additional cost, may help the clinician predict mortality and especially morbidity.

Surgical stress markers for postoperative complications: a prospective prognostic factor study

“…15 Recently, some scholars have proposed that the CRP/ALB ratio (CAR) can predict postoperative complications in a timely manner in colorectal cancer, and its predictive value is better than that of CRP alone. 16 This is consistent with Ranzani et al who examined CRP/albumin's ability to predict 90-day mortality in 334 patients. 17 These authors found that the CRP/albumin ratio >2 in patients with sepsis/septic shock provided the highest sensitivity and responsiveness in predicting 90-days mortality.…”

Prognostic value of preoperative glucose to lymphocytes ratio in patients with resected gastric cancer

“…This study analyzed the relationship between gastric cancer and the ability of GLR, NLR, and CAR to determine the prognosis. CAR and NLR are inflammatory response markers that effectively predict the prognosis in various cancers [13][14][15]. Zhong et al stated that GLR has an essential role in determining the prognosis in pancreatic cancer patients, and that GLR alone is more effective in determining the average overall survival than NLR and CAR [12].…”

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

“…Ghoneima et al [16] found that the preoperative CRP, haemoglobin (Hb), and ALB levels can act as predictors of septic complications in CD patients after surgery. Recently, some scholars have proposed that the CRP/ALB ratio (CAR) can predict postoperative complications in a timely manner in colorectal cancer, and its predictive value is better than that of CRP alone [17,18]. Thus, the postoperative CAR including ALB and CRP not only reflects nutritional status, but also is associated with the systemic inflammatory response after surgery.…”