The C-reactive protein-to-prealbumin ratio predicts fistula closure

BackgroundThe purpose of this study was to evaluate the predictability of fistula closure using the ratio of C-reactive protein to prealbumin (C:P ratio).MethodsA 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.ResultsThe 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.ConclusionOur results suggest that the C:P ratio is a predictor of fistula closure.