Diagnostic accuracy of the postoperative C - reactive protein to albumin ratio in prediction of complications after major abdominal surgery

Abstract

Introduction: postoperative complications are common after surgery for both benign and malignant disease, and results in infections, extended hospital stay, delayed return to normal status, increased financial burden and long-term morbidity hence early recognition of surgical complications and management is of utmost importance. Aim: To assess the predictive value of C-reactive protein to albumin ratio (CAR) and C-reactive protein (CRP) in determining the post-operative complications following major abdominal surgeries. Methods: this two-year prospective observational study was carried out at acharya vinoba bhave hospital and risk factors for post-operative complications in 100 eligible patients who were undergone major abdominal surgeries were identified using uni and multivariate analysis. Cut Coff values, PPV, sensitivity and specificity of CAR and CRP was analysed by ROC curve. Results: in our study 62% patient developed post-operative complications and CAR on post-op. day three found to be independent risk factor for prediction of post-op. complication and has higher PPV than CRP. CAR cut-off value of 2.16 is associated with more post op complications. Conclusion: From our study it can be hypothesized that patients having CAR value of more than 2.16 on post op day 3 should be monitored carefully for development of complications. So that early intervention could reduce the unwanted sequelae associated with it.

Keywords

• clavien-dindo classification
• c - reactive protein
• infections
• major abdominal surgery postoperative complications