Hubungan ILA dengan  Infeksi, Burst Abdomen, dan Ileus Obstruktif Komplikasi Pascaoperasi pada Kanker Kolorektal: Lymphocyte-Albumin Index and Postoperative Complications in Colorectal Cancer (Infection, Abdominal Dehiscence, and Obstructive Ileus): A Retrospective Cohort Study

Pande Ayu Kirana Dewi; I Made Mulyawan; Kadek Budi Santosa

doi:10.35473/jhhs.v8i2.758

Authors

Pande Ayu Kirana Dewi Universitas Udayana
I Made Mulyawan Universitas Udayana
Kadek Budi Santosa Universitas Udayana

DOI:

https://doi.org/10.35473/jhhs.v8i2.758

Keywords:

Colorectal Cancer, Lymphocyte-Albumin Index, Postoperative Complications, Immunonutrition Biomarker

Abstract

Colorectal cancer surgery carries substantial risk of postoperative complications surgical site infection, burst abdomen, and obstructive ileus that worsen morbidity and mortality. The Lymphocyte-Albumin Index (LAI), integrating immune and nutritional status, is a potential prognostic biomarker. To evaluate the association between preoperative LAI and postoperative infection, burst abdomen, and obstructive ileus in colorectal cancer patients at Prof. I.G.N.G Ngoerah Hospital. A retrospective cohort study of 72 colorectal cancer patients operated between January and December 2024, followed for 30 days postoperatively. LAI was calculated as absolute lymphocyte count (cells/µL) × serum albumin (g/dL). Controls were patients without complications during the same observation period. Associations were analyzed using Independent t-Test, Mann-Whitney U, Spearman correlation, and ROC analysis. LAI was significantly lower in infection (5.14), burst abdomen (5.40), and ileus (5.45) groups versus controls (7.25; p < 0.05). A significant negative correlation was found (r = −0.421; p < 0.001). The initial AUC of 0.219 fell below the reference line, indicating reversed classification direction; the direction-corrected AUC (1−AUC) of 0.781 indicated fair discriminative ability. Lower LAI is associated with higher postoperative complication risk, with fair discriminative capacity after direction correction; prospective validation with multivariate adjustment is warranted.

ABSTRAK

Kanker kolorektal sering disertai komplikasi pascaoperasi seperti infeksi luka operasi, burst abdomen, dan ileus obstruktif yang meningkatkan morbiditas dan mortalitas. Indeks Limfosit-Albumin (ILA), parameter gabungan status imun dan nutrisi, berpotensi menjadi biomarker prognostik komplikasi tersebut. Menganalisis hubungan ILA preoperatif dengan kejadian infeksi, burst abdomen, dan ileus obstruktif pascaoperasi pada pasien kanker kolorektal di RSUP Prof. I.G.N.G Ngoerah. Studi kohort retrospektif pada 72 pasien kanker kolorektal yang menjalani operasi Januari–Desember 2024, ditelusuri hingga 30 hari pascaoperasi. ILA dihitung dari limfosit absolut (sel/µL) dikalikan albumin serum (g/dL); kelompok kontrol adalah pasien tanpa komplikasi pada periode observasi yang sama. Hubungan dianalisis dengan Independent t-Test, Mann-Whitney U, korelasi Spearman, dan kurva ROC. ILA secara signifikan lebih rendah pada kelompok infeksi (5,14), burst abdomen (5,40), dan ileus (5,45) dibandingkan kontrol (7,25; p < 0,05). Terdapat korelasi negatif bermakna (r = -0,421; p < 0,001). Nilai AUC awal (0,219) berada di bawah garis referensi, menunjukkan arah klasifikasi terbalik; nilai terkoreksi (1-AUC = 0,781) menunjukkan kemampuan diskriminatif sedang. ILA rendah berhubungan dengan peningkatan risiko komplikasi pascaoperasi kanker kolorektal, dengan kemampuan diskriminatif sedang setelah koreksi arah; validasi prospektif dengan penyesuaian multivariat diperlukan.

ABSTRAK

Kanker kolorektal sering disertai komplikasi pascaoperasi seperti infeksi luka operasi, burst abdomen, dan ileus obstruktif yang meningkatkan morbiditas dan mortalitas. Indeks Limfosit-Albumin (ILA), parameter gabungan status imun dan nutrisi, berpotensi menjadi biomarker prognostik komplikasi tersebut. Menganalisis hubungan ILA preoperatif dengan kejadian infeksi, burst abdomen, dan ileus obstruktif pascaoperasi pada pasien kanker kolorektal di RSUP Prof. I.G.N.G Ngoerah. Studi kohort retrospektif pada 72 pasien kanker kolorektal yang menjalani operasi Januari–Desember 2024, ditelusuri hingga 30 hari pascaoperasi. ILA dihitung dari limfosit absolut (sel/µL) dikalikan albumin serum (g/dL); kelompok kontrol adalah pasien tanpa komplikasi pada periode observasi yang sama. Hubungan dianalisis dengan Independent t-Test, Mann-Whitney U, korelasi Spearman, dan kurva ROC. ILA secara signifikan lebih rendah pada kelompok infeksi (5,14), burst abdomen (5,40), dan ileus (5,45) dibandingkan kontrol (7,25; p < 0,05). Terdapat korelasi negatif bermakna (r = -0,421; p < 0,001). Nilai AUC awal (0,219) berada di bawah garis referensi, menunjukkan arah klasifikasi terbalik; nilai terkoreksi (1-AUC = 0,781) menunjukkan kemampuan diskriminatif sedang. ILA rendah berhubungan dengan peningkatan risiko komplikasi pascaoperasi kanker kolorektal, dengan kemampuan diskriminatif sedang setelah koreksi arah; validasi prospektif dengan penyesuaian multivariat diperlukan.

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