The Systemic Inflammation-Based Prognostic Score Predicts Postoperative Complications in Patients Undergoing Pancreaticoduodenectomy
Received 6 January 2021
Accepted for publication 22 February 2021
Published 9 March 2021 Volume 2021:14 Pages 787—795
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Guangzhen Qu, Dong Wang, Weiyu Xu, Kai Wu, Wei Guo
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
Correspondence: Wei Guo Email [email protected]
Background: Although many studies have confirmed the correlation between inflammation-based or nutritional markers and postoperative complications in patients undergoing colorectal cancer surgery, their correlation after undergoing pancreaticoduodenectomy (PD) remains unclear.
Methods: We retrospectively reviewed the clinical data of patients who underwent PD in Beijing Friendship hospital between 2018 and 2020. Univariate analysis, multivariate analysis, and receiver operating characteristic curve (ROC) were performed. We assessed the preoperative modified Glasgow Prognostic Score (mGPS), C-reactive protein/albumin ratio (CAR), C-reactive protein (CRP), postoperative Glasgow Prognostic Score (poGPS), CRP on postoperative day 3 (POD3) and CAR on POD3. The optimal cut-off values were determined by performing logistic regression analysis.
Results: Of the 172 patients who underwent PD, 74 (43.0%) developed complications, of whom 27 (15.7%) had clinically relevant postoperative pancreatic fistulas (CR-POPF) and 36 (20.9%) had positive drainage fluid cultures. Elevated levels of preoperative mGPS (P< 0.001), poGPS (P< 0.001), CRP (P< 0.001) and CAR on POD3 were associated with postoperative complications. CRP on POD3 (OR=1.028, 95% CI=1.017– 1.039, P< 0.001) was an independent risk factor associated with postoperative complications in both univariate and multivariate analyses. CAR on POD 3 showed the largest area under the curve (AUC=0.883, P< 0.001). Compared with CAR< 4.86, CAR ≥ 4.86 on POD3 was associated with a higher probability of complications (85.5% vs 14.6%, P< 0.001), especially CR-POPF (33.3% vs 4.9%, P< 0.001), intra-abdominal infection (36.2% vs 10.7%, P< 0.001) with a positive drainage fluid culture.
Conclusion: CAR, an inflammatory response-based marker, can effectively predict early postoperative complications in patients undergone PD.
Keywords: C-reactive protein, albumin, Glasgow Prognostic Score, pancreaticoduodenectomy, complications prediction
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]