Can the C-reactive protein-to-plasma albumin ratio be an alternative scoring to show mortality and morbidity in patients with colorectal cancer?

BACKGROUND: This study aims to demonstrate the sensitivity and specificity of C-reactive protein to plasma albumin (CRP/ALB) ratio in predicting morbidity and mortality in patients operated for colorectal cancer followed up in the intensive care unit by comparing it with current scoring systems.
METHODS: The data of patients who underwent surgery for colorectal cancer and hospitalized in the intensive care unit between 2015–2018 with available data were retrospectively analyzed in this study. The CRP/ALB ratio, the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) prepared for both gastrointestinal and colorectal surgery, and the Association of Coloproctology of Great Britain and Ireland (ACPGBI-CRC) scoring system prepared for colorectal patients, were compared to determine their success in predicting mortality and morbidity.
RESULTS: A total of 119 patients were included in this study. Mortality was observed in nine patients and morbidity was observed in 38 patients. When compared with P-POSSUM, which is the only scoring system showing morbidity, the CRP/ALB ratio was found to have a high prediction accuracy. The C reactive protein to plasma albumin ratio values was found to have lower power than P-POSSUM, CR-POSSUM and ACPGBI-CRC.
CONCLUSION: Although scoring systems are useful in predicting morbidity and mortality in colorectal patients, they are difficult to use in practice since they include many parameters. that the findings obtained in this study suggest that the CRP/ALB ratio, which can be calculated without any additional cost, may help the clinician predict mortality and especially morbidity.

Kolorektal kanserli hastalarda C-reaktif protein ve plazma albumin seviyesinin oraný mortalite ve morbiditeyi göstermede alternatif bir skorlama olabilir mi?

AMAÇ: Bu çalýþmada, kolorektal kanser nedeniyle ameliyat edilen ve yoðun bakýmda takip edilen hastalarda, C-reaktif proteinin plazma albüminine oranýnýn (CRP/ALB), güncel skorlama sistemleri ile karþýlaþtýrýlarak, morbidite ve mortaliteyi ön görmedeki sensitivite ve spesifitesini ortaya koymak amaçlanmýþtýr.
GEREÇ VE YÖNTEM: Kliniðimizde 2015–2018 yýllarý arasýnda verilerine ulaþýlabilen kolorektal kanser nedeniyle ameliyat olan ve yoðun bakýmda yatan hastalarýn verileri geriye dönük incelendi. CRP/ALB, hem gastrointestinal hemde kolorektal cerrahi için hazýrlanan, physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) ve kolorektal hastalar için hazýrlanan “Association of Coloproctology of Great Britain and Ireland” (ACPGBI-CRC) skorlama sistemlerinin mortalite ve morbidite ön görmedeki baþarýlarý karþýlaþtýrýldý.
BULGULAR: Toplam 119 hasta çalýþmada deðerlendirilmeye alýndý. Hastalarýn dokuzunda mortalite, 38’inde morbidite olduðu görüldü. Morbiditeyi gösteren tek skorlama sistemi olan P-POSSUM ile kýyaslandýðýnda CRP/ALB oranýnýn daha yüksek bir doðrulukla ön görüsü olduðu bulundu. Mortaliteyi göstermede, CRP/ALB deðerinin P-POSSUM, CR-POSSUM ve ACPGBI-CRC’ye oranla daha zayýf olduðu tespit edildi.
TARTIÞMA: Skorlama sistemleri kolorektal hastalarda morbidite ve mortaliteyi tahmin etmede kullanýþlý olsa dahi pratikte çok fazla parametre içerdikleri için kullanýmlarý zordur. Bu çalýþmanýn sonuçlarýna göre, ek maliyet getirmeden hesaplanabilecek CRP/ALB oranýnýn mortalite ve özellikle morbiditeyi tahmin etmede klinisyene yardýmcý olabileceðini düþünüyoruz.