Preoperative albumin-to-fibrinogen ratio predicts severe postoperative complications in elderly gastric cancer subjects after radical laparoscopic gastrectomy
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 ca...
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| Published in | BMC cancer Vol. 19; no. 1; pp. 931 - 8 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
18.09.2019
BioMed Central Ltd BMC |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1471-2407 1471-2407 |
| DOI | 10.1186/s12885-019-6143-x |
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| 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. |
|---|---|
| AbstractList | 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 ([greater than or equai to]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 [greater than or equai to] 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. Keywords: Gastric cancer, Severe postoperative complications, Predictor, Albumin, Fibrinogen 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. 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. 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. Preoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy. 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. Elderly patients ([greater than or equai to]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 [greater than or equai to] 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. 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. Preoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy. 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. 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. 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. 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.BACKGROUNDA 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.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.METHODSElderly 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.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.RESULTSA 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.Preoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy.CONCLUSIONSPreoperative AFR level is a useful predictor for SPCs in elderly GC subjects after radical laparoscopic gastrectomy. |
| ArticleNumber | 931 |
| Audience | Academic |
| Author | Song, Jie Gan, Linguang You, Xuexue Shen, Huachun Zhou, Qun Chen, Junping |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31533682$$D View this record in MEDLINE/PubMed |
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| Keywords | Albumin Severe postoperative complications Predictor Gastric cancer Fibrinogen |
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| PublicationTitle | BMC cancer |
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| Snippet | Background
A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed to... A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed to investigate... Background A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed to... Abstract Background A high prevalence of postoperative complications is closely associated with a worse short- and long-term outcome. This current study aimed... |
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| SubjectTerms | 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 |
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| Title | Preoperative albumin-to-fibrinogen ratio predicts severe postoperative complications in elderly gastric cancer subjects after radical laparoscopic gastrectomy |
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