Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Gohil, Rohit; Rishi, Majed; Tan, Benjamin H.L.

doi:10.9734/bjmmr/2014/5444

Cited by 26 publications

(26 citation statements)

References 19 publications

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“…Finally, our study showed that preoperative inflammation was associated with a longer postoperative LOS. This is consistent with previous studies, which showed that elevated NLR predicted perioperative complications and was associated with increased LOS for patients undergoing resection for CRC [15,30]. This finding has profound implications for patient care and highlights the usefulness of a simple, inexpensive biomarker that correlates the inflammatory state with colon cancer to its impact on hospitalisation.…”

Section: Discussionsupporting

confidence: 91%

Significance of Body Composition and Systemic Inflammation in Patients with Operable Colon Cancer Treated with Curative Intent

Hong¹,

Rouse²,

Moore³

et al. 2019

ACO

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Background: Muscle abnormalities and systemic inflammation have been associated with cancer progression and poor disease outcomes in patients with colon cancer. These factors are easily evaluated and can potentially be modified to improve outcomes. The objective of this study is to investigate the relationship between computed tomography (CT) derived measures of body composition, including low muscle mass (sarcopenia) and low muscle radiodensity (myosteatosis). It will also examine their association with systemic inflammation and determine whether these factors impact hospital length of stay for patients undergoing resection of their primary colorectal cancer. Methods: This study included 133 patients with stage I to III colon cancers diagnosed from 2011 through 2018 who underwent resection with curative intent. CT scans were used to identify sarcopenia and myosteatosis using predefined sex-specific and body mass index (BMI)-specific thresholds. The primary measure for systemic inflammation was the neutrophil-to-lymphocyte ratio. Tumour and patient characteristics were recorded. The primary outcome was hospital length of stay. Associations between body composition and systemic inflammation were examined using linear regression analyses, and their relationship with post-surgical length of stay was determined using logistic regression analyses. Results: A significant proportion of patients were overweight or obese (60.9%). Sarcopenia and myosteatosis were highly prevalent (41.4% and 39.1% respectively). Muscle mass and muscle radiodensity were not significantly correlated with each other. Male sex (p < 0.001) and higher BMI (p < 0.001) were associated with greater muscle mass. Male sex (p = 0.020) was also associated with greater muscle radiodensity but higher BMI (p < 0.001) was associated with lower muscle radiodensity. Inflammation was present in 39.1% of patients. Elevated neutrophil-to-lymphocyte ratio was associated with longer length of stay (OR 1.29, 95% CI 1.04-1.61, p = 0.019). Conclusion: Sarcopenia and myosteatosis were prevalent among colon cancer patients, despite many of them being overweight or obese. Systemic inflammation was associated with prolonged length of stay post-surgery and could potentially be utilised to delineate patients with poorer recovery and who may benefit from additional monitoring or interventions to reduce the length of hospitalisation. These commonly collected markers could enhance prognostication and identify patients with a poorer outcome.

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Section: Discussionsupporting

confidence: 91%

Significance of Body Composition and Systemic Inflammation in Patients with Operable Colon Cancer Treated with Curative Intent

Hong¹,

Rouse²,

Moore³

et al. 2019

ACO

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“…4 Sonoda et al, Montomoli et al, and Gohil et al, showed that the preoperative serum albumin has an impact on the morbidity following colorectal surgery in their respective studies. [8][9][10] In the present study preoperative serum albumin less than 3.5g/dl has highest complication (48.9%) and death (14.2%) than albumin more than or equal to 3.5g/dl (3.1% and 0%) which is statistically significant with a p value less than 0.0001 and the majority of complications occurred in patients with albumin less than 2.5g/dl to 3g/dl. This study implies that as the albumin level decreases, the risk of postoperative morbidity and mortality increases.…”

Section: Discussionsupporting

confidence: 48%

Preoperative serum albumin level as a predictor of surgical complications after emergency abdominal surgery

2019

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Background: Hypoalbumenia has been shown to be associated with increased morbidity and mortality in acute surgical patients due to increased catabolism. This study intends to correlate between hypoalbumenia and postoperative complications in patients undergoing emergency abdominal surgery. Methods: A prospective study is done in a rural tertiary care centre in a total of 190 patients undergoing emergency abdominal surgery after obtaining ethical clearance. In this study preoperative serum albumin and postoperative complications including death up to postoperative day thirty were recorded and gathered using a checklist designed for the study and analysed. Serum albumin less than 3.5g/dl is considered as hypoalbumenia in this study. The correlation between preoperative serum albumin and postoperative morbidity and mortality is assessed. Results: In a total of 190 patients, 93 (48.9%) patients had morbidity and 27 (14.2%) patients had mortality. Preoperative serum albumin less than 3.5g/dl is found in 120 (63.1%) cases and 70 (36.9%) patients has same or more than 3.5g/dl. Patients with preoperative serum albumin less than 3.5g/dl has morbidity in 87 (45.8%) patients than that of normal preoperative serum albumin level which is 6 (3.1%) cases (p= <0.0001, chi-square =72.31). The total mortality is 27 (14.2%) in which all mortality is found in low albumin group compared to no mortality in patients with normal serum albumin. As the albumin level decreases the risk of morbidity and mortality increases with majority of complication in this study occurring in patients with albumin group less than 2.5g/dl to 3g/dl. Conclusions: Preoperative serum albumin is a good predictor of surgical outcome after emergency abdominal surgery.

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“…This finding was supported by Kubo et al [17] who found that infectious complications were significantly associated with the NLR. Similarly, Gohil et al [18] reported that the preoperative NLR value was associated with an increased hospital length of stay.…”

Section: Introductionmentioning

confidence: 89%

“…Similarly, Gohil et al . reported that the preoperative NLR value was associated with an increased hospital length of stay.…”

Section: Introductionmentioning

confidence: 99%

The neutrophil‐to‐lymphocyte ratio predicts major perioperative complications in patients undergoing colorectal surgery

et al. 2016

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Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Cited by 26 publications

References 19 publications

Significance of Body Composition and Systemic Inflammation in Patients with Operable Colon Cancer Treated with Curative Intent

Significance of Body Composition and Systemic Inflammation in Patients with Operable Colon Cancer Treated with Curative Intent

Preoperative serum albumin level as a predictor of surgical complications after emergency abdominal surgery

The neutrophil‐to‐lymphocyte ratio predicts major perioperative complications in patients undergoing colorectal surgery

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