Predictive Value Of Inflammatory Indices For Postoperative Complications In Patients After Curative Resection For Colorectal Cancer

Objective: To investigate the associated risk factors for postoperative complications in patients undergoing curative resection for colorectal cancer and evaluate the predictive value of associated inflammatory indices for postoperative complications in patients with colorectal cancer.Methods: A total of 200 patients with colorectal cancer who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University between January 2017 and December 2021 and underwent curative resection of colorectal cancer were divided according to the type of inflammatory index of patients mentioned above and complications after curative surgery,differences between clinical data of patients in each group were compared,and relevant risk factors for postoperative complications among patients who underwent curative resection of colorectal cancer were analyzed,statistical analysis was performed using SPSS software,The t-test or rank sum test was used to compare measurement data,and the χ 2 test or Fisher’s exact probability method was used to compare count data.Multivariate regression analysis was performed using binary logistic regression.Results: Two hundred patients were predominantly elderly men,postoperative infection was the main type of complication after curative surgery for colorectal cancer,and group comparisons according to the type of relevant inflammatory index showed that patients in the high PLR group had lower levels of hemoglobin,total cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol than patients in the low PLR group,whereas procalcitonin levels were higher;Moreover,patients in the high PLR group were more likely to have postoperative infection,postoperative sepsis,postoperative anastomotic leakage,postoperative peritonitis,and postoperative ileus;Patients in the high NLR group had longer hospital stays and lower levels of hemoglobin,total cholesterol,HDL cholesterol,and LDL cholesterol,but higher levels of aspartate aminotransferase,total bilirubin,and procalcitonin;Moreover,patients in the high NLR group had more bulge type tumors than patients in the low NLR group,in addition,the high NLR group had more occurrence of postoperative infection,postoperative sepsis,postoperative anastomotic leakage,postoperative peritonitis,and postoperative ileus;Patients in the high SII group spent longer in hospital and had patients consuming alcohol,had lower levels of hemoglobin,total cholesterol,HDL cholesterol,LDL cholesterol,but higher levels of total bilirubin and procalcitonin;Moreover,patients in the high SII group were more likely to have tumors invading blood vessels,and patients in the low SII group were more likely to have tumors of the bulge type,in addition,patients in the high SII group were more likely to have postoperative infection,postoperative sepsis,postoperative anastomotic leakage,postoperative peritonitis,postoperative bleeding,postoperative ileus,and postoperative lower extremity venous thrombosis;Patients in the high MII group had longer hospital stays,lower levels of hemoglobin,total cholesterol,HDL cholesterol,LDL cholesterol,and higher procalcitonin levels than patients in the low MII group.And they were more likely to have tumor invasion into blood vessels,in addition,the high MII group had more postoperative infections,postoperative sepsis,postoperative anastomotic leakage,postoperative peritonitis,postoperative bleeding,postoperative ileus and postoperative lower extremity venous thrombosis,and postoperative death;In the analysis of risk factors associated with postoperative complications in patients with colorectal cancer,the results of univariate analysis showed that the postoperative infection group had a predominance of male patients aged<60 years,a longer hospital stay,lower hemoglobin and TC levels,higher procalcitonin levels,and more frequent tumor invasion and vascular invasion compared with patients in the noninfection group.Furthermore,patients in the postoperative infection group had a higher PLR,NLR,SII compared with patients in the noninfection group MII levels.Patients in the postoperative anastomotic leak group had a longer hospital stay compared with patients in the non anastomotic leak group,lower levels of red blood cell count,hemoglobin,TC,LDL-C,higher procalcitonin levels,and were more likely to have tumor invasion into blood vessels,in addition,patients in the postoperative anastomotic leak group had higher PLR,NLR,SII,and MII levels compared with patients in the non anastomotic leak group.Patients in the postoperative thrombus group had lower red blood cell count,hemoglobin,TC,and LDL-C levels compared with those in the non thrombus group,were more likely to have tumor invasion to nerves and vessels,and had higher NLR,SII,and MII levels compared with patients in the postoperative thrombus group.Binary logistic regression analysis showed that high procalcitonin(OR=1.063,95%CI 1.014-1.115),high MII level(OR=48.391,95%CI18.741-124.95)were independent risk factors for postoperative infection in colorectal cancer patients;Long hospital stay(OR=1.034,95%CI 1.008-1.061),high MII level(OR=9.209,95%CI 3.506-24.188)were independent risk factors for postoperative anastomotic leakage in colorectal cancer patients.High MII level(OR=7.151,95%CI 2.543-20.111)was an independent risk factor for postoperative lower extremity venous thrombosis in colorectal cancer patients.Conclusions:Colorectal cancer patients with a high preoperative inflammatory index had a longer hospital stay and lower HGB,TC,HDL-C,and LDL-C levels,while those with a higher PCT level were more likely to have tumor invasion of surrounding vessels,postoperative infection,postoperative sepsis,postoperative anastomotic leak,postoperative peritonitis,postoperative ileus,and postoperative lower extremity venous thrombosis than patients with a high preoperative inflammatory index,High MII level is an independent risk factor for postoperative complications in patients after curative resection for colorectal cancer,and such patients should be paid increased attention and prompt symptomatic management.