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THE ROLE OF C-REACTIVE PROTEIN/ALBUMIN RATIO IN DETERMINING ILEUS TYPE AND PROGNOSIS

Year 2022, Volume: 29 Issue: 1, 121 - 126, 01.03.2022
https://doi.org/10.17343/sdutfd.1063380

Abstract

Objective
Recently, the CRP / albumin ratio, a combination
of blood markers for systemic inflammation
and nutritional status, has been found to be an
independent prognostic marker in patients with
infection, malignancy, and other diseases. In our
study, we aimed to investigate the effectiveness of the
CRP-albumin ratio at admission in predicting the ileus
type and prognosis in hospitalized patients.
Material and Methods
Patients over the age of 18 who applied to the emergency
department and were later diagnosed with ileus were
included in the study. Demographic characteristics,
laboratory parameters, surgical intervention, length
of stay and in-hospital mortality of the patients were
determined. It is divided into paralytic or mechanical
according to its etiology. The CRP/albumin ratio (CAR)
was calculated, and the effect of CAR in predicting the
ileus type and mortality was investigated.
Results
A total of 116 patients were investigated. 72 (62.1%)
of the patients were male and the mean age was 65.12
years. Mechanical ileus was detected in 81 (69.8%) of
them. According to ileus types, 66.7% of patients with
mechanical ileus received medical treatment, while
97.1% of patients with paralytic ileus received medical
treatment. Medical treatment was more common in
patients with paralytic ileus (p<0.001). The CAR value
was found to be 3.72 in patients with mechanical ileus
and 5.77 in patients with paralytic ileus (p=0.046). In
the logistic regression analysis examining CAR, WBC,
length of stay, neutrophil and lymphocyte count, and
CRP value in all ileus patients, it was revealed that no
parameter was an independent indicator for mortality.
Conclusion
The CAR value can be useful in determining ileus
type. While it may be useful in predicting mortality in
ileus patients, it is not an independent indicator.

References

  • Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000; 87: 1240–1247.
  • Thijs, L.G.; Hack, C.E. Time course of cytokine levels in sepsis. Intensiv. Care Med. 1995, 21, S258–S263.
  • Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703.
  • Kim, M.H.; Ahn, J.Y.; Song, J.E.; Choi, H.; Ann, H.W.; Kim, J.K.; Kim, J.H.; Jeon, Y.D.; Kim, S.B.; Jeong, S.J.; et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS ONE 2015, 10.
  • Saito, H.; Kono, Y.; Murakami, Y.; Shishido, Y.; Kuroda, H.; Matsunaga, T.; Fukumoto, Y.; Osaki, T.; Ashida, K.; Fujiwara, Y. Prognostic significance of the preoperative ratio of C-reactive protein to albümin and neutrophil-lymphocyte ratio in gastric cancer patients. World J. Surg. 2017.
  • Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin Ratio be Used as a New Indicator of Activation in Patients with Uveitis? Ocul Immunol Inflamm. 2021 Jul 4;29(5):1017-1022. doi: 10.1080/09273948.2020.1714061.
  • Kim M, Park YG, Park YH. C-reactive protein/albumin ratio as an indicator of disease activity in Behçet's disease and human leukocyte antigen-B27-associated uveitis. Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1985-1992.
  • Liu A, Lv H, Tan B, Shu H, Yang H, Li J, Qian J. Accuracy of the highly sensitive C-reactive protein/albumin ratio to determine disease activity in inflammatory bowel disease. Medicine (Baltimore). 2021 Apr 9;100(14): e25200.
  • Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget. 2018 Jan 11;9(17):13934-13947.
  • Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC. Ileus in Adults. Dtsch Arztebl Int. 2017 Jul 24;114(29-30):508-518.
  • Vilz TO, Pantelis D, Kalff JC. Prophylaxis and therapy of postoperative ileus. Chirurgische Praxis. 2013; 76:407–420.

C-REAKTİF PROTEİN/ALBUMİN ORANININ İLEUS TİPİNİ VE PROGNOZU BELİRLEMEDEKİ YERİ

Year 2022, Volume: 29 Issue: 1, 121 - 126, 01.03.2022
https://doi.org/10.17343/sdutfd.1063380

Abstract

Amaç
Son zamanlarda, sistemik inflamasyon ve beslenme
durumu için bu belirteçlerin bir kombinasyonu olan
CRP/albümin oranı, enfeksiyon, malignite ve diğer
hastalıkları olan hastalarda bağımsız bir prognostik
belirteç olduğu saptanmıştır. Çalışmamızda, ileus tanısı
ile hastaneye yatan hastalarda başvuru anındaki
CRP-albumin oranının ileus nedenini ve prognozu
tahmin etmedeki etkinliğini araştırmayı amaçladık.
Gereç ve Yöntem
Çalışmaya acil servise başvuran ve sonrasında ileus
tanısı alan 18 yaş üstü hastalar alınmıştır. Hastaların
demografik özellikleri, laboratuvar parametreleri, cerrahi
müdahale geçirip geçirmedikleri, yatış süreleri
ve hastane içi mortaliteleri belirlenmiştir. Etiyolojisine
göre paralitik veya mekanik olarak ayrılmıştır. CRP/
albümin oranı (CAR) hesaplanmış, CAR’ın ileus nedeni
ve mortaliteyi tahmin etmedeki etkisi araştırılmıştır.
Bulgular
Toplam 116 hasta araştırıldı. Hastaların 72 (%62,1)’si
erkek, yaş ortalaması 65,12’di. 81 (%69,8)’inde mekanik
ileus saptandı. İleus tiplerine göre mekanik ileus
hastalarının %66,7’si medikal tedavi alırken, paralitik
ileusta%97,1’i medikal tedavi aldığı saptandı. Paralitik
ileus hastalarında tedavi tercihi daha fazla orandı medikaldi
(p<0,001). Mekanik ileus olan hastaların CAR
değeri 3,72, paralitik ileus olanların ise 5,77 saptandı.
(p=0,046) Bütün ileus hastalarında CAR, WBC, yatış
süresi, nötrofil ve lenfosit sayısı, CRP değerinin incelendiği
lojistik regresyon analizinde hiçbir parametrenin
mortalite için bağımzsız bir gösterge olmadığı
ortaya çıkmıştır.
Sonuç
CAR değeri ileus tipini belirlemede faydalı olabilir.
İleus hastalarında mortalite tahmininde yararlı görülebilirken
bağımsız bir gösterge değildir.

References

  • Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000; 87: 1240–1247.
  • Thijs, L.G.; Hack, C.E. Time course of cytokine levels in sepsis. Intensiv. Care Med. 1995, 21, S258–S263.
  • Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703.
  • Kim, M.H.; Ahn, J.Y.; Song, J.E.; Choi, H.; Ann, H.W.; Kim, J.K.; Kim, J.H.; Jeon, Y.D.; Kim, S.B.; Jeong, S.J.; et al. The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy. PLoS ONE 2015, 10.
  • Saito, H.; Kono, Y.; Murakami, Y.; Shishido, Y.; Kuroda, H.; Matsunaga, T.; Fukumoto, Y.; Osaki, T.; Ashida, K.; Fujiwara, Y. Prognostic significance of the preoperative ratio of C-reactive protein to albümin and neutrophil-lymphocyte ratio in gastric cancer patients. World J. Surg. 2017.
  • Bozkurt E, Muhafiz E, Sengul D, Uçak T, Atum M. Can the CRP/albumin Ratio be Used as a New Indicator of Activation in Patients with Uveitis? Ocul Immunol Inflamm. 2021 Jul 4;29(5):1017-1022. doi: 10.1080/09273948.2020.1714061.
  • Kim M, Park YG, Park YH. C-reactive protein/albumin ratio as an indicator of disease activity in Behçet's disease and human leukocyte antigen-B27-associated uveitis. Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1985-1992.
  • Liu A, Lv H, Tan B, Shu H, Yang H, Li J, Qian J. Accuracy of the highly sensitive C-reactive protein/albumin ratio to determine disease activity in inflammatory bowel disease. Medicine (Baltimore). 2021 Apr 9;100(14): e25200.
  • Wu J, Tan W, Chen L, Huang Z, Mai S. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis. Oncotarget. 2018 Jan 11;9(17):13934-13947.
  • Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC. Ileus in Adults. Dtsch Arztebl Int. 2017 Jul 24;114(29-30):508-518.
  • Vilz TO, Pantelis D, Kalff JC. Prophylaxis and therapy of postoperative ileus. Chirurgische Praxis. 2013; 76:407–420.
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Bora Çekmen 0000-0003-3348-8375

Giray Kolcu 0000-0001-8406-5941

Publication Date March 1, 2022
Submission Date January 26, 2022
Acceptance Date February 1, 2022
Published in Issue Year 2022 Volume: 29 Issue: 1

Cite

Vancouver Çekmen B, Kolcu G. C-REAKTİF PROTEİN/ALBUMİN ORANININ İLEUS TİPİNİ VE PROGNOZU BELİRLEMEDEKİ YERİ. Med J SDU. 2022;29(1):121-6.

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