Postoperatif 7. Gün C-Reaktif Protein/Albümin Oranı ile Cerrahi Komplikasyonların Öngörülmesi: Kolon Kanseri Hastalarında Erken Risk Belirleme Aracı

Abstract

Amaç: Bu çalışma, elektif kolorektal kanser cerrahisi sonrası gelişebilecek cerrahi komplikasyonların öngörülmesinde, postoperatif 7. gün ölçülen C-reaktif protein/albumin oranının (CAR) prediktif değerini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Ocak 2017 ile Aralık 2023 tarihleri arasında küratif amaçlı kolorektal rezeksiyon uygulanan 200 hasta retrospektif olarak incelendi. Demografik ve perioperatif veriler ile 30 günlük postoperatif komplikasyonlar değerlendirildi. CRP ve albumin düzeyleri, ameliyat öncesi ve postoperatif 7. günde ölçüldü. CAR, CRP (mg/dL) değerinin albumin (g/dL) değerine bölünmesiyle hesaplandı. Komplikasyonlar Clavien–Dindo sınıflamasına göre değerlendirildi. Bulgular: Hastaların %40’ında postoperatif komplikasyon gelişti. Komplikasyon gelişen grupta postoperatif 7. gün CRP düzeyleri daha yüksek, albumin düzeyleri ise daha düşük bulundu; buna bağlı olarak CAR değeri anlamlı düzeyde yüksekti (ortalama CAR: 5.07 ± 2.05 vs. 2.31 ± 1.12; p<0.001). CAR değeri ≥3.2 olan hastalarda komplikasyon oranı belirgin olarak yüksekti. Ayrıca, komplikasyon gelişen hastalarda hastanede kalış süresi daha uzundu (medyan: 12 gün vs. 7 gün; p<0.001). Sonuç: Postoperatif 7. gün ölçülen CAR değeri, kolorektal kanser cerrahisi sonrası gelişebilecek komplikasyonları öngörmede basit, düşük maliyetli ve etkili bir biyobelirteç olabilir. CAR takibi, erken dönemde yüksek riskli hastaların belirlenmesine yardımcı olarak klinik yönetim kararlarının şekillendirilmesine katkı sağlayabilir.

Keywords

• CRP
• Kolorektal kanser
• CAR
• postoperatif komplikasyon

Supporting Institution

AMASYA ÜNİVERSİTESİ

Ethical Statement

ETİK ONAY AMASYA ÜNİVERSİTESİ ETİK KURULUNDAN ,23.05.2025 TARİHİNDE, Sayı : E-76988455-050.01-263366 NUMARASI İLE ALINMIŞTIR.

Thanks

AMASYA ÜNİVERSİTESİ ŞEREFEDDİN SABUNCUOĞLU EĞİTİM ARAŞTIRMA HASTANESİ GENEL CERRAHİ VE MİKROBİOLOJİ ÇALINŞANLARINA TEŞEKKÜR EDERİM.

C-Reactive Protein to Albumin Ratio: Is it a Predictor of Surgical Complications in Colorectal Cancer Surgery?

Abstract

Aim: This study aimed to evaluate the predictive value of the C-reactive protein to albumin ratio (CAR), measured on postoperative day 7, for identifying surgical complications following elective colorectal cancer surgery. Materials and Methods: A retrospective analysis was conducted on 200 patients who underwent curative colorectal resections between January 2017 and December 2023. Demographic and perioperative data, as well as 30-day postoperative complications, were reviewed. CRP and albumin levels were assessed preoperatively and on postoperative day 7. CAR was calculated as CRP (mg/dL) divided by albumin (g/dL). Complications were classified according to the Clavien–Dindo system. Results: Postoperative complications occurred in 40% of patients. On day 7, those with complications had significantly higher CRP levels, lower albumin levels, and elevated CAR values (mean CAR: 5.07 ± 2.05 vs. 2.31 ± 1.12; p<0.001). A CAR value of ≥3.2 was associated with a notably higher rate of complications. Additionally, patients with complications had a significantly longer hospital stay (median: 12 vs. 7 days; p<0.001). Conclusion: The postoperative day-7 CAR is a simple and cost-effective biomarker that may assist in identifying patients at higher risk of surgical complications after colorectal cancer surgery. Monitoring CAR in the early postoperative period may support risk stratification and guide clinical decision-making.

Keywords

• C-Reactive Protein
• CRP to Albumin ratio
• Postoperative complications
• kolorectal cancer

Supporting Institution

Amasya University

Ethical Statement

Ethical approval was obtained from the Amasya University Ethics Committee on May 23, 2025, with the reference number E-76988455-050.01-263366

Thanks

The authors would like to thank the staff of the Department of General Surgery and the Department of Microbiology at Amasya University Şerefeddin Sabuncuoğlu Training and Research Hospital for their valuable contributions

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