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The C-reactive protein-to-prealbumin ratio predicts fistula closure
Suzanne Harriman1, Nadia Rodych, Paul Hayes
1Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0W8, Canada.
Background:
The purpose of this study was to evaluate the predictability of fistula closure using the ratio of C-reactive protein to prealbumin (C:P ratio).
Methods:
A database of 89 patients with gastrointestinal fistulas (1994-2009) was created based on the records of our Nutrition Support Services Team. All patients had weekly blood work including C-reactive protein level, prealbumin level, and albumin level. Forty-three fistulas were managed without surgery for 6 weeks or more; of these, 29 closed.
Results:
The median C:P ratio for those fistulas that remained open after 6 weeks of conservative management differed significantly from those that closed (.10 vs .35; P < .001). For patients with a C:P ratio of .25 or less, fistula closure occurred in 87.0% (95% confidence interval, 74.0-94.3), whereas for patients with a ratio of greater than 1.0, no fistulas closed.
Conclusion:
Our results suggest that the C:P ratio is a predictor of fistula closure.
