Predictive value of CRP/albumin ratio in major abdominal surgery.
INTRODUCTION
Surgical site infection (SSI) is a major cause of morbidity, resulting in significant healthcare and economic implications. The ability to predict patients at high risk of SSI may enable targeted follow-up and management. This study sought to examine the relationship between the CRP/albumin ratio in the prediction of SSI in patients undergoing emergency major abdominal surgery.


METHODS
A retrospective study of all patients who underwent emergency major abdominal surgery in our institution over 2 years was performed. Patients were identified from a prospectively maintained database of SSI's and cross-referenced with hospital records. Patient demographics including age, gender, ASA grade, and wound classification (clean, clean/contaminated, contaminated, and dirty) were collated.


RESULTS
CRP preoperatively of greater than 5 was statistically significant in predicting an SSI (P < 0.05). In addition, preoperative serum albumin of < 32 was also significant in predicting a superficial site infection. Interestingly, preoperative CRP/albumin ratio did not predict SSI, but postoperative CRP/albumin ratio was predictive at both 24 and 48 hour time points (P < 0.05). Median length of stay in the SSI group was statistically significantly longer at 27.88 days (range 7-76) versus 18.32 days (1-56) (P < 0.01).


CONCLUSIONS
Though CRP and albumin have merit in isolation in preoperative identification of patients at risk of SSI, CRP/albumin ratio is a useful postoperatively adjunct in predicting SSI postoperatively at 24 and 48hrs postoperatively.
['Donlon|Noel E|NE|', 'Mohan|Helen|H|', 'Free|Ross|R|', 'Elbaghir|Badr|B|', 'Soric|Igor|I|', 'Fleming|Christina|C|', 'Balasubramanian|Ischwaria|I|', 'Ivanovski|Ivan|I|', 'Schmidt|Karl|K|', 'Mealy|Ken|K|']
D000005:Abdomen D000368:Aged D000418:Albumins D002097:C-Reactive Protein D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D012189:Retrospective Studies D013530:Surgical Wound Infection
CRP Albumin Major abdominal surgery Surgical site infection Laparotomy