The C-reactive protein to albumin ratio predicts postoperative complication in patients who undergo gastrectomy for gastric cancer

Lee, Jinwon; Sharma, Ashish Ranjan; Lee, Sang-Soo; Chun, Wan Joo; Kim, Hae Sung

doi:10.1016/j.heliyon.2020.e04220

Cited by 9 publications

(9 citation statements)

References 22 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CAR, as a novel index, has proved to provide useful prognostic information for sepsis, abdominal surgeries, cancer, or emergency laparotomy. 10 , 11 , 12 , 13 , 30 However, the cut‐off selected for use are often inconsistent, even quite different. For example, Hu et al 31 used 0.24 as cut‐off value to predict the overall survival in patients with osteosarcoma and Shi et al used 0.27 to predict periprosthetic joint infection, both of which were 3‐fold as ours (0.09); while in a study of gastric cancer, Aoyama et al 12 found the optimal cut‐off point of CAR was 0.05 to optimally evaluate the overall survival and recurrence‐free survival.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation‐based prognostic factors have attracted increasing attention in multiple settings, largely because they combine the systemic inflammatory status and pathological burden. C‐reactive protein to albumin ratio (CAR) has demonstrated its effectiveness in predicting clinical outcomes or adverse events in a range of conditions, for example, cancers of liver, 9 lung, 10 pancreas 11 and intestines/stomach, 12 , 13 severe burn injury, 14 or musculoskeletal disorders. 15 , 16 , 17 Specified at postoperative infection, Goulart et al 18 identified CAR on postoperative day 3 as an independent predictor after colorectal cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

C‐reactive protein to albumin ratio (CAR) in predicting surgical site infection (SSI) following instrumented posterior lumbar interbody fusion (PLIF)

Sun

et al. 2022

International Wound Journal

View full text Add to dashboard Cite

Identification of novel markers would contribute to the individualised risk assessment and development of a risk prediction model. This study aimed to investigate the role of the C‐reactive protein to albumin ratio (CAR) in predicting surgical site infection (SSI) following instrumented posterior lumbar interbody fusion (PLIF) of lumbar degenerative diseases. This study enrolled patients who underwent PLIF and instrumentation for treatment of lumbar degenerative diseases between 2015 and 2020. Electronic medical records were inquired for data collection, with follow‐up register for identifying SSI cases. The optimal cut‐off for CAR was determined by constructing the receiver operator characteristic (ROC) curve. Patients with high‐ or low‐CAR value were compared using the univariate analyses, and the association between CAR and the risk of SSI was investigated using multivariate logistics regression analysis. A total of 905 patients were enrolled, twenty‐nine (3.2%) had developed an SSI with 72.4% occurring during index hospitalisation, and 11 (1.2%) had deep and 18 (2.0%) superficial SSIs. An SSI was associated with additional 10.7 days of index total hospital stay (P = .001). The CAR was 0–5.43 (median, 0.05), and the optimal cut‐off was 0.09 and area under the curve was 0.720 (P < .001). 336 (37.1%) patients had a CAR ≥0.09 and 22 (6.5%) developed an SSI, with a crude risk of 5.6 relative to those with a low CAR. The multivariate analyses showed CAR ≥0.09 was associated with 8.06‐fold increased risk of SSI, together with diabetes (P = .018), while hypertension was identified as a protective factor (OR, 0.34; 95%CI, 0.11–1.00, P = .049). High CAR is found to significantly predict the incident SSI following instrumented PLIF of lumbar degenerative diseases, and can be considered as a useful index in practice only after it is verified by future high‐level evidences.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

C‐reactive protein to albumin ratio (CAR) in predicting surgical site infection (SSI) following instrumented posterior lumbar interbody fusion (PLIF)

Sun

et al. 2022

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…Furthermore, those authors reported that a high CAR was an independent risk factor for surgical site infection (22). In addition, Lee et al evaluated the relationship between the CAR and perioperative surgical complications in 128 patients with gastric cancer (24). They demonstrated that the CAR was an independent prognostic factor of perioperative surgical complications (HR=2.832, p=0.045).…”

Section: Discussionmentioning

confidence: 99%

“…For example, Saito et al evaluated the CAR as a prognostic factor in 453 patients with stage I-IV gastric cancer, setting the cut-off value at 0.0232 according to a receiver operating characteristic analysis (30). Toiyama et al evaluated the CAR as a prognostic factor in 384 patients with stage I-III gastric cancer (24), setting the cut-off value at 0.051 according to their own receiver operating characteristics analysis. In addition, Li et al evaluated the CAR as a prognostic factor in 258 patients with stage IV gastric cancer (26), setting the cut-off value at 0.5897.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Influence of the C-Reactive Protein-to-Albumin Ratio in Patients Who Received Curative Treatment for Gastric Cancer

Aoyama

Nakazono

Segami

et al. 2021

In Vivo

View full text Add to dashboard Cite

Background: We investigated the impact of the pre-surgical C-reactive protein-to-albumin ratio (CAR) on survival and recurrence after curative treatment for gastric cancer. Patients and Methods: This study included 481 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified. Results: A CAR of 0.05 was regarded as the optimal critical point of classification considering the 3-and 5-year survival rates and patients were divided according to their CAR. The OS rates at 3 and 5 years after surgery were significantly higher at 92.5% and 87.9%, respectively, in the low-CAR group compared with 84.9% and 71.9%, respectively, in the high-CAR group. The corresponding RFS rates were 89.1% and 85.5%, and 81.0% and 72.2%, respectively, also a significant difference. A multivariate analysis demonstrated that the CAR was a significant independent risk factor for the OS and marginally significant independent risk factor for the RFS. In addition, the incidences of pancreatic fistula and abdominal abscess were significantly higher and the rate of introduction of adjuvant chemotherapy significantly lower in the high-CAR group. Conclusion: The CAR was a risk factor influencing survival in patients who underwent curative treatment for gastric cancer. An effective perioperative care plan and surgical strategy need to be developed according to the CAR.

show abstract

“…Among the markers using albumin and CRP, unlike GPS and mGPS, which are classified as absolute values, CAR is a useful index indicating the ratio of albumin and CRP. Several previous studies have suggested that the CAR value can reflect the postoperative short-term outcomes in various kinds of diseases [ 78 , 79 ]. There are also papers analyzing the correlation between postoperative morbidity and preoperative CAR in CRC patients.…”

Section: Markers Available Through Blood Chemistry Testsmentioning

confidence: 99%

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer

Shim

Kim

et al. 2022

Ann Coloproctol

View full text Add to dashboard Cite

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

show abstract

The C-reactive protein to albumin ratio predicts postoperative complication in patients who undergo gastrectomy for gastric cancer

Cited by 9 publications

References 22 publications

C‐reactive protein to albumin ratio (CAR) in predicting surgical site infection (SSI) following instrumented posterior lumbar interbody fusion (PLIF)

C‐reactive protein to albumin ratio (CAR) in predicting surgical site infection (SSI) following instrumented posterior lumbar interbody fusion (PLIF)

The Clinical Influence of the C-Reactive Protein-to-Albumin Ratio in Patients Who Received Curative Treatment for Gastric Cancer

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer

Contact Info

Product

Resources

About