Preoperative albumin-to-fibrinogen ratio predicts severe postoperative complications in elderly gastric cancer subjects after radical laparoscopic gastrectomy

BMC Cancer

Huachun Shen¹  Junping Chen¹  Linguang Gan¹  Xuexue You²  Qun Zhou²  Jie Song² 

[1] Department of Anesthesiology, HwaMei Hospital, University of Chinese Academy of Sciences;Department of Anesthesiology, Jiangxi Maternal and Child Health Hospital;

关键词: Gastric cancer;    Severe postoperative complications;    Predictor;    Albumin;    Fibrinogen;   

DOI  :  10.1186/s12885-019-6143-x

来源: DOAJ

【 摘 要 】

Abstract Background A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed to investigate potential risk factors including albumin-to-fibrinogen ratio (AFR) for severe postoperative complications (SPCs) in surgical gastric cancer (GC) patients. Methods Elderly patients (≥65 years) with primary GC who underwent elective radical laparoscopic gastrectomy under general anesthesia were included. According to the Clavien–Dindo classification system, the severity of complications was assessed from Grade I to V and SPCs were defined as C-D Grade ≥ IIIa. The clinicopathological features, operative-associated characteristics, postoperative recovery and laboratory tests were compared between patients with or without SPCs. Receiver operating characteristic (ROC) curve analysis using Youden’s Index was established for determining the predictive value and cut-off threshold of AFR for SPCs. Binary univariate and multivariate logistic regression models were used to assess factors influencing SPCs. Results A total of 365 elderly GC patients were finally included in the analysis, of which 52 (52/365, 14.2%) patients had developed SPCs within postoperative 30 days. Preoperative AFR level predicted SPCs in surgical GC patients with an AUC of 0.841, a sensitivity of 76.36% and a specificity of 80.77%, respectively (P < 0.001). The multivariate analysis revealed that a lower AFR level (OR: 1.94, 95% CI: 1.09–3.36, P = 0.017) and an older age (OR: 1.81, 95% CI: 1.06–3.04, P = 0.023) were two independent predictive factors for SPCs in surgical GC patients. Conclusions Preoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy.

【 授权许可】

Unknown