Nikolouzakis Taxiarchis Konstantinos, Alegakis Athanasios, Niniraki Maria, Kampa Marilena, Chrysos Emmanouel
Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Greece.
Department of Forensic Sciences and Toxicology, Faculty of Medicine, Crete University, 71003 Heraklion, Greece.
J Clin Med. 2025 Jun 18;14(12):4341. doi: 10.3390/jcm14124341.
Postoperative septic events represent a major paramevter of morbidity and mortality following major abdominal surgery. Early identification and prediction can have a major impact on clinical management, reduction of hospitalization costs, and restriction of irrational use of antibiotics. For this purpose, two novel biomarkers (C-reactive protein to albumin or transferrin ratios, CAR and CTR, respectively) were evaluated. : A combined retrospective and prospective study of 200 patients who underwent elective or emergency open abdominal surgery was performed. Patient demographics, emergency status, type of operation, and white blood cell (WBC) count, serum albumin (ALB), serum transferrin (TRF), and CAR-CTR were evaluated. Multiple-way ANOVA was utilized. Multiparametric and logistic regression analyses were performed for each confounder. Receiver operating characteristic (ROC) curve analysis and corresponding diagrams of sensitivity vs 1-specificity were applied for CAR and CTR in postoperative days 2 and 3. : WBC number had no predictive significance in septic event identification ( = 0.461), while postoperative CAR, CTR, ALB, TRF, BMI, and emergency status were significantly correlated ( < 0.001). At postoperative day 2, a CTR of 9.48 and a CAR of 4.14 have 75.9% and 70.4% specificity and 86% and 87.7% sensitivity, respectively. At postoperative day 3, a CTR of 8.89 and a CAR of 4.25 have 74.1% and 79.6% specificity and 87.7% and 86% sensitivity, respectively. : Early identification of postoperative septic events may significantly facilitate decreasing postoperative morbidity and mortality. Both CAR and CTR displayed significant predictive ability in identifying patients prone to developing postoperative septic events, highlighting their significance in everyday clinical practice.
术后感染事件是腹部大手术后发病率和死亡率的主要参数。早期识别和预测对临床管理、降低住院费用以及限制抗生素的不合理使用具有重大影响。为此，对两种新型生物标志物（分别为C反应蛋白与白蛋白或转铁蛋白的比率，即CAR和CTR）进行了评估。：对200例行择期或急诊开腹手术的患者进行了一项回顾性和前瞻性的联合研究。评估了患者的人口统计学特征、急诊状态、手术类型以及白细胞（WBC）计数、血清白蛋白（ALB）、血清转铁蛋白（TRF）和CAR-CTR。采用多因素方差分析。对每个混杂因素进行多参数和逻辑回归分析。在术后第2天和第3天，对CAR和CTR应用受试者工作特征（ROC）曲线分析以及敏感性与1-特异性的相应图表。：白细胞数量在感染事件识别中无预测意义（P = 0.461），而术后CAR、CTR、ALB、TRF、BMI和急诊状态具有显著相关性（P < 0.001）。在术后第2天，CTR为9.48和CAR为4.14时，特异性分别为75.9%和70.4%，敏感性分别为86%和87.7%。在术后第3天，CTR为8.89和CAR为4.25时，特异性分别为74.1%和79.6%，敏感性分别为87.7%和86%。：早期识别术后感染事件可能显著有助于降低术后发病率和死亡率。CAR和CTR在识别易发生术后感染事件的患者方面均显示出显著的预测能力，突出了它们在日常临床实践中的重要性。
