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

• Published in: BMC cancer Vol. 19; no. 1; pp. 931 - 8
• Main Authors: You, Xuexue, Zhou, Qun, Song, Jie, Gan, Linguang, Chen, Junping, Shen, Huachun
• Format: Journal Article
• Language: English
• Published: London BioMed Central 18.09.2019; BioMed Central Ltd; BMC
• Subjects: Administrative support; Aged; Aged, 80 and over; Albumin; Anesthesia; Anesthesiology; Biomarkers; Biomedical and Life Sciences; Biomedicine; Blood; Cancer; Cancer patients; Cancer Research; Care and treatment; Childrens health; Committees; Complications and side effects; Elderly patients; Epidemiology; Female; Fibrin; Fibrinogen; Fibrinogen - analysis; Gastrectomy; Gastric cancer; Geriatrics; Health aspects; Health Promotion and Disease Prevention; Hospitals; Humans; Joint surgery; Laboratories; Laparoscopy; Male; Maternal & child health; Medical research; Medicine/Public Health; Metastasis; Mortality; Multivariate analysis; Oncology; Patient outcomes; Patients; Postoperative Complications; Predictor; prevention and public health; Proteins; Regression analysis; Research Article; Retrospective Studies; Risk factors; Serum Albumin, Human - analysis; Severe postoperative complications; Statistical analysis; Stomach cancer; Stomach Neoplasms - complications; Stomach Neoplasms - metabolism; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Studies; Surgeons; Surgery; Surgical Oncology; Surgical techniques; Tumor necrosis factor-TNF; United States > US; China; Albumin; Severe postoperative complications; Predictor; Gastric cancer; Fibrinogen
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-019-6143-x

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.