Prognostic value of novel serological markers in predicting postoperative complications of ileocecal resection in Crohn's disease patients.

Abstract

<b>Introduction:</b> Crohn's disease (CD) is a chronic inflammatory bowel disease frequently necessitating surgical intervention, particularly ileocecal resection (ICR), due to complications unresponsive to medical therapy. Postoperative complications remain a significant concern, highlighting the need for reliable preoperative biomarkers to improve risk stratification.<b>Aim:</b> This study aimed to evaluate the utility of selected serologic inflammatory markers in predicting postoperative complications and their severity in CD patients undergoing ICR.<b>Materials and methods:</b> A retrospective analysis was conducted on 110 patients who underwent ICR for CD-related complications between 2015 and 2024. Preoperative blood parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and C-reactive protein (CRP), were analyzed in relation to postoperative complications classified by Clavien-Dindo grading and the Comprehensive Complication Index (CCI).<b>Results:</b> Postoperative complications occurred in 46 patients (41.8%), with surgical site infection being the most common. Severe complications (Clavien-Dindo grade IV) were observed in 5 patients, with no mortality recorded. While no statistically significant associations were found between Clavien-Dindo grade and white blood cells (WBC), platelets (PLT), NLR, MPV, or CRP levels, CRP demonstrated a significant positive correlation with CCI score (p < 0.05), suggesting its potential as a predictive marker for overall complication burden.<b>Conclusions:</b> Elevated preoperative CRP levels may serve as a useful predictor of postoperative complication severity in CD patients undergoing ICR. Although other markers, such as NLR and MPV, showed trends toward association, statistical significance was not reached. Comprehensive preoperative assessment incorporating inflammatory biomarkers could enhance surgical planning and improve outcomes in this high-risk population.