Correlation between preoperative systemic inflammation and postoperative infection in patients with gastrointestinal cancer: A multicenter study

Purpose: Our aim was to examine the association between postoperative infection and preoperative systemic inflammation in patients undergoing resection of gastrointestinal cancer. Methods: We studied 862 patients who underwent elective gastrointestinal cancer surgery at six institutions. The levels of C-reactive protein and albumin were included as parameters of preoperative systemic inflammation measured using the Glasgow prognostic score. The Glasgow prognostic score was calculated based on the admission data as follows: patients with an elevated level of C-reactive protein (>1.0 mg/dl) and hypoalbuminemia (<3.5 g/dl) were allocated a score of 2, while patients showing one or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. The significance of the Glasgow prognostic score for predicting postoperative infection was analyzed using a multivariate analysis. Results: After surgery, 182 (21 %) patients developed postoperative infections. According to a multivariate analysis, the Glasgow prognostic score (p < 0.01) was independently associated with an increased risk of developing a postoperative infection. When the postoperative infections were divided into surgical site infections and remote site infections, the Glasgow prognostic score was significantly associated with an increased risk of developing remote site infections. Conclusions: Preoperative systemic inflammation is associated with postoperative infection in patients undergoing resection of gastrointestinal cancer.