CRP/Albumin Ratio as a Predictive Inflammatory Marker for Postoperative SIRS and/or Sepsis

Study Overview
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Brief Summary
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The goal of this observational study is to determine the value of CRP/Albumin Ratio as an inflammatory marker for predicting the development of postoperative Systemic Inflammatory Response Syndrome and/or Sepsis in polytraumatized patients admitted to Intensive care unit. The main question it aims to answer is whether CRP/Albumin Ratio can be used as predictive inflammatory marker for postoperative Systemic Inflammatory Response Syndrome and/or Sepsis or not.

Detailed Description
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The development of postoperative Systemic Inflammatory Response Syndrome (SIRS) or Sepsis is a very serious complication that has been associated with high morbidity, mortality, and increased length of inpatient stay. Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. As surgical interventions lead to well-understood metabolic, neuroendocrine, and immune responses, the stress responses to surgery contribute to increased postoperative complications mostly caused by increased levels of Pro-inflammatory cytokines in response to surgical injury, which leads to changes of circulating acute phase proteins, such as albumin and C-reactive protein (CRP). The CRP to albumin ratio (CAR) is a new index calculated by dividing CRP by the albumin level. It has been assumed to have predictive value in determining morbidity and mortality in many critical diseases.

Official Title
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C-Reactive Protein / Albumin Ratio as a Predictive Inflammatory Marker for Postoperative Systemic Inflammatory Response Syndrome and/or Sepsis in Polytraumatized Patients in ICU

Conditions
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Crp

Intervention / Treatment
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* Diagnostic Test: CRP and Albumin level in blood sample


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients classified by American Society of Anesthesiologists physical status (ASA) as I to III. Both sex. Aged ≥ 18 years old. Polytraumatized patients (fulfilling the 'New Berlin definition' of Polytrauma patient which includes Abbreviated Injury Scale (AIS) ≥3 for two or more different body regions with one or more of the following five physiological variables: Disturbed level of consciousness, hypotension, coagulopathy, acidosis and age >70y). Admitted to Intensive Care Unit preoperatively or postoperatively. • Surgical intervention within 48 hours of the onset of Trauma. Exclusion Criteria: Patients who used immunosuppressive therapy and chemotherapy. Patients with known hematological disorders or malignancy. Patients with known liver cirrhosis classified as Child- Pugh C ( serum Albumin < 2.8 mg/dl or INR> 2.2 ) (Tsoris , et al.,2023) or liver cell failure. Patients receiving Albumin Supplementation during the period of the study. Age < 18y.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: CRP and Albumin level in blood sample|CRP and Albumin levels will be measured from blood samples of the patients to determine CRP/Albumin Ratio|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluate the relation of CRP/ albumin ratio to the prediction of postoperative SIRS or sepsis in polytrauma patients. | Evaluate the relation of CRP/ albumin ratio to the prediction of postoperative SIRS or sepsis in polytrauma patients. | The patients will be evaluated for 5 days postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| evaluate the relation of CRP / albumin ratio to the occurrence of postoperative infection as surgical site infection or pulmonary infection . | evaluate the relation of CRP / albumin ratio to the occurrence of postoperative infection as surgical site infection or pulmonary infection . | The patients will be evaluated for 5 days postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CRP/ALBUMIN Ratio, Systemic inflammatory response syndrome, Sepsis, postoperative