Abstract
Background: Colorectal cancer is among the leading causes of cancer-related mortality worldwide. Surgery remains the cornerstone of treatment for colorectal cancer; however, postoperative complications can significantly impact patient outcomes. Identifying reliable preoperative markers to predict postoperative outcomes is crucial for improving patient care and management. Inflammation plays a critical role in the pathogenesis and progression of various diseases, including cancer. Preoperative biomarkers such as C-reactive protein (CRP), hemoglobin (Hb), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) have been studied for their predictive value in postoperative outcomes. This study aims to evaluate the significance of these biomarkers in predicting complications, focusing on postoperative renal function, hospital stay, and the incidence of surgical site infections. Methods: This retrospective study included 100 patients who underwent colorectal surgery between January 2023 and January 2024 at Yemeni French Hospital. Preoperative levels of CRP, Hb, NLR, and PLR were recorded. Postoperative outcomes, including wound infection, chest infection, deep vein thrombosis (DVT), pulmonary embolism (PE), dehiscence, redo surgery, readmission, and death, were analyzed. Statistical analysis was performed using t-tests and chi-square tests. Results: Thirty patients had preoperative CRP >20 mg/L, forty patients had CRP between 10-20 mg/L, and thirty patients had CRP <10 mg/L. Twenty-five patients reported preoperative Hb >14 g/dL, fifty patients had Hb between 12-14 g/dL, and twenty-five patients had Hb <12 g/dL. Preoperative NLR was >4 in twenty-eight patients, 2-4 in forty-five patients, and <2 in twenty-seven patients. Lastly, PLR was >150 in thirty patients, between 100-150 in forty patients, and <100 in thirty patients. High preoperative CRP levels (>20 mg/L) significantly predicted wound and chest infections (p=0.04 and p=0.03, respectively). Elevated NLR (>4) and PLR (>150) were also significantly associated with wound and chest infections. Hb levels >14 g/dL were associated with lower risks of these infections. Elevated preoperative CRP and NLR were significantly associated with longer hospital stays, higher postoperative creatinine levels, and increased incidence of postoperative complications, including wound infection, dehiscence, chest infection, UTI, anastomotic leak, redo operation, and readmission. PLR showed a moderate correlation with these outcomes. Conclusions: Preoperative CRP, NLR, and PLR levels are significant predictors of postoperative infections in colorectal surgery patients. Monitoring these biomarkers can aid in identifying high-risk patients and improving postoperative care strategies. Understanding the relationship between these markers and postoperative complications can aid in better risk stratification and targeted interventions.
Published Version
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