Crohn’s Disease: New Predictive Marker for Complications After Surgery

In a study published on Hindawi, a team of scientists have discovered that the C-reactive protein to albumin (CAR) ratio can be used to predict the risk of complications following surgery in people living with Crohn’s disease, which is a type of inflammatory bowel disease. The researchers found that patients with a higher CAR were more likely to have complications of both mild and high severity.

About Crohn’s Disease

Crohn’s disease is a form of inflammatory bowel disease which can impact any area of the digestive tract. The cause of the illness is not well understood, but a combination of environmental, genetic, bacterial, and immune system factors could play a role; smoking tobacco appears to increase risk. The disease is often identified in the teen years or early adulthood. While abnormal immune system behavior is also present, it is not considered an autoimmune disease. Symptoms include weight loss, abdominal distension, bowel obstruction, diarrhea, fever, abdominal pain, fatigue, and inflammation spreading to other areas (eyes, joints, etc.). Patients are at an elevated risk of cancer impacting the digestive tract. Treatment includes changes to diet, stopping smoking, steroids, immunosuppressants, and certain surgical operations. Symptoms tend to relapse and remit, and some patients are able to live mostly normal lives. However, there is no cure for Crohn’s disease and treatment must continue for life. Patients have a slightly reduced life expectancy. To learn more about Crohn’s disease, click here.

Many patients can see symptom remission with medication, but some patients may eventually need surgery if they do not respond to drug therapy or if their disease progresses. The ability to predict the likelihood of complications can be of great value to these patients in order to improve their overall prognosis.

Study Results

In this study, a total of 534 patients living with Crohn’s disease and treated with surgery between 2016 and 2020 participated. From this pool of patients, the rate of postoperative complications stood at 32.2 percent. Patients that had a CAR of 3.25 or more had a longer stay in the hospital post-operation (15.5 days vs 9 days), more complications, and a greater rate of surgical site infections (48.2 percent vs 5.7 percent). 57.1 percent of patients in the high CAR group experienced mild complications compared to 10.9 percent in the low CAR group; 41.1 percent of high CAR patients experienced major complications compared to 7.7 percent in the low CAR group.

CAR has previously been used to predict postoperative complications in pancreatic cancer and colorectal cancer, and these results indicate that it can be a reliable predictor in Crohn’s disease as well.


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