Prognostic Value of Preoperative High-Sensitivity C-Reactive Protein/Albumin Ratio in Spinal Surgery

Abstract

Objective: The relation high-sensitivity C-reactive protein/albumin ratio (CAR) with perioperative adverse events have not been studied in patients undergoing spinal surgery (SS). This study aimed to evaluate the prognostic value of preoperative CAR on outcome of patients undergoing elective SS. Method: A retrospective analysis of 811 consecutive patients, older than 18 years old and undergoing elective SS between October 2014 and January 2019 was performed. Demographic and clinical data were obtained from medical records. Routine preoperative laboratory tests including high-sensitivity C-reactive protein and albumin levels were recorded. The outcomes of interest were perioperative medical and surgical complications during hospitalization. Results: The perioperative adverse event rate was 9.0% (73 patients). The CAR was higher in in the individuals that experienced complicated in-hospital course than in those who did not (30.2±27.5 vs. 15.8±24.5, p<0.001). Multivariate analysis showed that only age, higher CAR, and history of malignancy were significant and independent predictors of perioperative adverse events. The best cutoff value of the CAR was 5.25, with 84.3% sensitivity and 85.2% specificity. Conclusion: This is the first study to show an association between preoperative CAR and perioperative adverse events in patients undergoing SS.