Postoperative Ratio of C-Reactive Protein to Albumin as a Predictive Marker in Patients with Crohn’s Disease Undergoing Bowel Resection

Background. The ratio of C-reactive protein (CRP) to albumin (CAR) has a significant correlation with postoperative complications and acts as a predictor in patients with pancreatic cancer and colorectal cancer. However, whether the CAR can be used to predict complications in Crohn’s disease (CD) patients after surgery has not yet been reported. Methods. A total of 534 CD patients undergoing surgery between 2016 and 2020 were enrolled. The risk factors of postoperative complications were assessed by univariate and multivariate analyses. The cutoff values and the accuracy of diagnosis for the CAR and postoperative CRP levels were examined with receiver operating characteristic (ROC) curves. Results. The rate of postoperative complications was 32.2%. The postoperative CAR (OR 13.200; 95% CI 6.501-26.803; P < 0.001 ) was a significant independent risk factor for complications. Compared with the CRP level on postoperative day 3, the CAR more accurately indicated postoperative complications in CD patients (AUC: 0.699 vs. 0.771; Youden index: 0.361 vs. 0.599). ROC curves showed that the cutoff value for the CAR was 3.25. Patients with a CAR ≥ 3.25 had more complications ( P < 0.001 ), a longer postoperative stay ( 15.5 ± 0.6 d vs. 9.0 ± 0.2 d, P < 0.001 ), and more surgical site infections (48.2% vs. 5.7%, P < 0.001 ) than those with a CAR < 3.25 . Conclusions. Compared to the CRP level, the CAR can more accurately predict postoperative complications and can act as a predictive marker in CD patients after surgery.

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Adalimumab Treatment in Biologically Naïve Crohn’s Disease: Relationship with Ectopic MUC5AC Expression and Endoscopic Improvement

Gastroenterology Research and Practice ◽

10.1155/2014/687257 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Tsutomu Mizoshita ◽

Satoshi Tanida ◽

Hironobu Tsukamoto ◽

Keiji Ozeki ◽

Takahito Katano ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Activity Index ◽

Drug Efficacy ◽

Predictive Marker ◽

C Reactive Protein ◽

Reactive Protein ◽

Before And After ◽

Adalimumab Treatment ◽

Positive Groups

Background. Adalimumab (ADA) is effective for patients with Crohn’s disease (CD). However, there have been few reports on ADA therapy with respect to its relationship with pathologic findings and drug efficacy in biologically naïve CD cases.Methods. Fifteen patients with active biologically naïve CD were treated with ADA. We examined them clinically and pathologically with ectopic MUC5AC expression in the lesions before and after 12 and 52 weeks of ADA therapy, retrospectively.Results. Both mean CD activity index scores and serum C-reactive protein values were significantly lower after ADA therapy (P<0.001). In the MUC5AC negative group, all cases exhibited clinical remission (CR) and endoscopic improvement at 52 weeks. In MUC5AC positive groups, loss of MUC5AC expression was detected in cases having CR and endoscopic improvement at 52 weeks, while remnant ectopic MUC5AC expression was observed in those exhibiting no endoscopic improvement and flare up after 52 weeks.Conclusions. ADA leads to CR and endoscopic improvement in biologically naïve CD cases. In addition, ectopic MUC5AC expression may be a predictive marker of flare up and endoscopic improvement in the intestines of CD patients.

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C-reactive protein levels in the perioperative period as a predictive marker of endoscopic recurrence after ileo-colonic resection for Crohn’s disease

Cell Death Discovery ◽

10.1038/cddiscovery.2016.32 ◽

2016 ◽

Vol 2 (1) ◽

Cited By ~ 7

Author(s):

E Iaculli ◽

M Agostini ◽

L Biancone ◽

C Fiorani ◽

A Di Vizia ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Predictive Marker ◽

Perioperative Period ◽

Colonic Resection ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Endoscopic Recurrence

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P132 The level of serum C-reactive protein as a predictive marker of recurrence after ileo-colonic resection for Crohn's disease. Results of a longitudinal prospective study

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(13)60154-3 ◽

2013 ◽

Vol 7 ◽

pp. S61

Author(s):

E. Iaculli ◽

T. Giorgia ◽

C. Fiorani ◽

O. Sara ◽

L. Biancone ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Prospective Study ◽

Predictive Marker ◽

Colonic Resection ◽

C Reactive Protein ◽

Reactive Protein

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Effects of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on postoperative complications for patients with Crohn’s disease: a cohort study

10.21203/rs.3.rs-55359/v1 ◽

2020 ◽

Author(s):

Yan Wu ◽

Huaying Liu ◽

Weilin Qi ◽

Wei Liu ◽

Shasha Tang ◽

...

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Postoperative Complications ◽

Crohn's Disease ◽

Parenteral Nutrition ◽

Eligible Patient ◽

C Reactive Protein ◽

Reactive Protein ◽

Post Surgery ◽

Complication Risk

Abstract Background: Most patients with Crohn's disease (CD), a chronic inflammatory disease, need surgery but exhibit elevated postoperative complication incidences. ω-3 polyunsaturated fatty acids (PUFAs) are considered beneficial for nutrition, anti-inflammation, immunity and intestinal microflora balance in humans. This study assessed the effects of ω-3 PUFA-supplemented parenteral nutrition (PN) on postoperative complications in CD.Methods: Overall, 186 CD patients undergoing bowel resection were eligible. Patient data were collected from a prospectively maintained database. After surgery, 103 patients received ω-3 PUFA-supplemented PN; 83 did not. Postoperative complications were compared between the groups. Complication risk factors were identified by univariate and multivariate analyses.Results: Patients with ω-3 PUFA-supplemented PN after surgery had lower C-reactive protein levels (57.2±5.3 mg/L vs 43.5±3.9 mg/L, P=0.047) and shorter postoperative hospital stays (12.1±1.1 days vs 9.3±0.6 days, P=0.041) than those without. The ω-3 PUFA group exhibited significantly reduced incidences of overall complications (40.8% vs 24.1%, P=0.016) and major complications (23.3% vs 9.6%, P=0.014). Postoperative complications were associated with infliximab, ω-3 PUFAs, C-reactive protein, operative time, and laparoscopic surgery. Multivariate regression revealed that preoperative infliximab use and postoperative ω-3 PUFA-supplemented PN were independent risk factors in CD. Conclusions: ω-3 PUFA-supplemented PN reduced post-surgery inflammatory response in CD patients, thus decreasing postoperative complications and accelerating recovery.Trial registration: This trial was registered in ClinicalTrials.gov. Identifier was NCT03901937. The date of registration was 03/04/2019.

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