The predictive power of C-reactive protein- lymphocyte ratio for in-hospital mortality after colorectal cancer surgery.

ABSTRACT

BACKGROUND: The relation between immunity, inflammation, and tumor development and progression has been emphasized in colorectal cancer widely and the prognosis is linked to the inflammatory reaction of the host as well as the biological behavior of the tumor. AIM: In this study, we aimed to find out the predictive power of C-reactive protein- lymphocyte ratio (CLR) for in-hospital mortality after colorectal surgery. METHODS AND RESULTS: A series of 388 CRC patients were enrolled in the present retrospective study which was conducted in a tertiary state Hospital in Ankara, Turkey. In-hospital mortality was the main outcome to evaluate the predictive power of inflammatory markers, while the other outcomes that would be evaluated as separate variables were LOS in hospital and LOS in ICU. In this study, there were 260 males and 128 females, and the mean age was 60.9. The in-hospital mortality rate was 3.4% (n = 13) and age, APACHE II score and Charlson comorbidity index score were related to in-hospital mortality statistically. The mean LOS in the hospital was 13.9 days and LOS in ICU was 4.5 days. The CRP levels and the CLR levels were higher both in the preoperative and postoperative periods in the mortality (+) group and the difference was significant statistically (P = .008/ .002 and .004/ <.001, respectively). CLR in the postoperative period had the best predictive power with AUC 0.876. CONCLUSION: In conclusion, within the context of our study there appears to be a relationship between CLR, as measured on day 2 postoperatively, and in-hospital mortality. It is observed to be more effective than NLR, ALC, and CRP.