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Research Article Open access CC BY 3.0

Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Rohit Gohil, Majed Rishi, Benjamin H. L. Tan

Journal of Advances in Medicine and Medical Research · pp. 481–487 · Published 28 Sep 2013

10.9734/BJMMR/2014/5444

Abstract

Aims: Colorectal cancer is the third most common cancer in European populations. It has been shown previously that neutrophil-lymphocyte ratio (NLR), pre-operative albumin, and haemoglobin are useful prognostic indicators. The aim of this study was to assess how these factors influence the length of postoperative stay (LOS) following colorectal cancer surgery. Methodology: All patients undergoing elective colorectal resections for malignancy between 2010 and 2011 in Pilgrim Hospital, Boston, U.K. were considered for the study. Hospital archive systems were used to ascertain pre-operative NLR, albumin and haemoglobin levels. LOS was calculated from electronic discharge documents with day 1 being the day after surgery. Unifactorial and multifactorial analyses were performed to identify independent predictors of prolonged stay. Results: 196 patients were included in the study. Pre-operative haemoglobin was not associated with prolonged hospital stay. On univariate analysis, pre-operative serum albumin and pre-operative NLR were associated with prolonged hospital stay. On multivariate analysis, pre-operative serum albumin >34.5 g/dl (odds ratio, 0.47; 95% confidence interval, 0.24 – 0.92; p = 0.027) retained independent association for prolonged hospital stay .However, pre-operative NLR failed to reach statistical significance on multivariate analysis. Conclusions: Patients with low albumin and elevated NLR are more likely to have an increased hospital stay following colorectal cancer surgery. This may be useful for surgeons in terms of identifying the ‘high-risk’ patient post-operatively and allow for early intervention.

Colorectal cancer neutrophil-lymphocyte ratio serum albumin length of post-operative stay

References (21)

  1. 1 Estimates of the cancer incidence and mortality in Europe in 2006 [DOI]
  2. 2 Multimodal approach to control postoperative pathophysiology and rehabilitation [DOI]
  3. 3 Estimates of cancer incidence and mortality in Europe in 2008 [DOI]
  4. 4 Ratio of neutrophil to lymphocyte counts — rapid and simple parameter of systemic inflammation and stress in critically ill [DOI]
  5. 5 Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer [DOI]
  6. 6 Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population [DOI]
  7. 7 Albumin Concentrations Are Primarily Determined by the Body Cell Mass and the Systemic Inflammatory Response in Cancer Patients With Weight Loss [DOI]
  8. 8 The Neutrophil-Lymphocyte Count Ratio in Patients with Community-Acquired Pneumonia [DOI]
  9. 9 Postoperative morbidity and mortality following resection of the colon and rectum for cancer [DOI]
  10. 10 Low preoperative serum albumin in colon cancer: a risk factor for poor outcome [DOI]
  11. 11 Causes and mechanisms of hypoalbuminaemia [DOI]
  12. 12 Surgery for colorectal cancer in elderly patients: a systematic review. Colorectal Cancer Collaborative Group.
  13. 13 Hospital Cost Containment in the 1980s [DOI]
  14. 14 Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery [DOI]
  15. 15 Post-operative neutrophil–lymphocyte ratio predicts complications following colorectal surgery [DOI]
  16. 16 The relationship between hypoalbuminaemia, tumour volume and the systemic inflammatory response in patients with colorectal liver metastases [DOI]
  17. 17 Preoperative serum carcinoembryonic antigen, albumin and age are supplementary to UICC staging systems in predicting survival for colorectal cancer patients undergoing surgical treatment [DOI]
  18. 18 Determinants of prognosis in advanced colorectal cancer [DOI]
  19. 19 Iron‐deficiency anemia: A predictor of diminished disease‐free survival of T3N0M0 stage colon cancer [DOI]
  20. 20 Postoperative stay following colorectal surgery: a study of factors associated with prolonged hospital stay [DOI]
  21. 21 Perioperative Management of Colon Cancer Under Medicare Risk Programs [DOI]

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