Preoperative Albumin-to-Fibrinogen Ratio Predicts Postoperative Pneumonia in Patients with Esophageal Squamous Cell Carcinoma: A Retrospective Study

Abstract

Background: Postoperative pneumonia is the most common postoperative complication in patients with esophageal cancer. Prediction of postoperative pneumonia by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin, fibrinogen, albumin-to-fibrinogen ratio(AFR) , and other preoperative laboratory tests and postoperative pneumonia in patients with esophageal cancer after esophagectomy.Methods: Retrospective analysis was performed on 177 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from December 2018 to December 2019.Postoperative pneumonia was defined according to the revised Uniform Pneumonia Score(rUPS).Patients were divided into pneumonia and non-pneumonia groups for comparison of baseline data, perioperative indicators, and laboratory examination data.(Receiver operating characteristic)ROC curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR and other laboratory tests data. Univariate and multivariate logistic regression analyses were used to assess the risk factors for postoperative pneumoniaResults: Of the 177 patients, 32 (18%) developed postoperative pneumonia. The AUC value predicted by AFR using ROC curve analysis was 0.767, 65.6% sensitivity and 83.4% specificity. Multivariate logistic regression analysis showed that albumin (P=0.013), creatinine (P=0.01), and AFR (P=0.016) were independent risk factors for postoperative pneumonia.Conclusion: Preoperative AFR can effectively predict the occurrence of postoperative pneumonia in patients with esophageal cancer