{
  "abstract": "Introduction Postoperative morbidity remains frequent after surgery for ulcerative colitis (UC). Identifying simple preoperative biomarkers reflecting inflammatory and nutritional status may help predict early postoperative complications and optimise perioperative management.Methods We conducted a retrospective monocentric observational study including 95 UC patients undergoing surgery between 1995 and 2025, selected from a cohort of 601 patients followed in a tertiary referral centre. Patients operated on for non-UC indications or with incomplete data were excluded. Early postoperative morbidity was defined as complications occurring within 30 days after surgery. Clinical characteristics, treatment exposure, and preoperative laboratory parameters were analysed. The C-reactive protein/albumin ratio (CAR) was calculated as a composite inflammatory-nutritional biomarker. Factors associated with postoperative morbidity were assessed using univariate analysis and multivariable logistic regression.Results Mean age was 38 ± 13 years, with a male predominance (56%). Emergency surgery was performed in 27% of cases, mainly for acute severe colitis. Preoperative corticosteroids were used in 44% of patients, and immunosuppressive or biologic therapy in 18%. Early postoperative morbidity occurred in 21% (n = 20), predominantly infectious complications. Patients with complications were older (41 vs 36 years, p = 0.04), more frequently underwent emergency surgery (38% vs 23%, p = 0.05), and more often received preoperative corticosteroids (61% vs 38%, p = 0.03). They had lower haemoglobin levels (10.5 vs 11.9 g/dL, p = 0.04), higher CRP levels (65 vs 33 mg/L, p = 0.02), and lower albumin levels (28 vs 34 g/L, p = 0.03). The CAR was significantly higher in patients with postoperative morbidity (3.4 vs 1.7, p = 0.03), with a progressive increase across tertiles (p for trend = 0.02). In multivariable analysis adjusted for age, emergency surgery and corticosteroid exposure, elevated CAR (OR 2.6, 95% CI 1.1–6.4; p = 0.04) and preoperative corticosteroid therapy (OR 3.2, 95% CI 1.2–8.5; p = 0.02) remained independently associated with postoperative morbidity.Conclusions Early postoperative morbidity after UC surgery is strongly influenced by preoperative inflammatory and nutritional status. The CRP/albumin ratio is a simple and readily available biomarker that independently predicts postoperative complications. Preoperative optimisation strategies, including inflammation control, nutritional support and corticosteroid tapering, may help reduce postoperative morbidity and improve surgical outcomes.",
  "authors": [
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Yassine Mohamed Dassar"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Nawal Lagdali"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Mohamed Borahma"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Maryeme Kadiri"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Fatimazahra Chabib"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Selma Sabbah"
    },
    {
      "affiliations": [
        "Medicine Department C, Ibn Sina University Hospital Center, Mohamed 5 University, Rabat, Morocco"
      ],
      "name": "Fatimazohra Ajana"
    }
  ],
  "title": "P218 Preoperative CRP/albumin ratio predicts early postoperative morbidity after surgery for ulcerative colitis",
  "uid": "3d416a3c-4d79-50e9-bc5c-64e58a1c5fe3"
}