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Article

The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG

by
Suat Evirgen
1,* and
Sirin Cetin
2
1
Department of General Surgery, Medical Faculty, Amasya University, Amasya 05100, Turkey
2
Department of Bioistatistical, Medical Faculty, Amasya University, Amasya 05100, Turkey
*
Author to whom correspondence should be addressed.
Complications 2025, 2(3), 16; https://doi.org/10.3390/complications2030016
Submission received: 9 May 2025 / Revised: 21 June 2025 / Accepted: 1 July 2025 / Published: 7 July 2025
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Abstract

Background/Objectives: This study aimed to evaluate the prognostic significance of preoperative inflammatory biomarkers—C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—in predicting early postoperative complications (within 30 days) in patients undergoing percutaneous endoscopic gastrostomy (PEG). Methods: Data from 184 patients who underwent PEG placement at our institution between January 2021 and May 2022 were retrospectively analyzed. Demographic characteristics, PEG indications, and preoperative laboratory parameters (CRP, albumin, neutrophils, lymphocytes, and platelets) were recorded. CAR was calculated as the ratio of CRP (mg/L) to albumin (g/dL). Complications occurring within 30 days post-procedure were defined as early postoperative complications. Patients with and without complications were compared, and logistic regression analysis was used to identify potential risk factors. Results: The mean age of the patients was 71.5 ± 5.9 years, and 58.7% were male. PEG indications included neurological dysphagia (54.3%), head and neck malignancies (21.7%), and other causes (23.9%). At least one early complication occurred in 26 patients (14.1%). There were no significant differences in age, sex, body mass index, or Charlson Comorbidity Index between patients with and without complications (p > 0.05). Logistic regression revealed that elevated CAR was an independent predictor of postoperative complications (OR = 2.88; 95% CI: 1.62–5.13; p < 0.001). Although NLR (OR = 1.34) and PLR (OR = 1.02) were also associated with increased risk, they were less predictive than CAR in multivariate analysis. Conclusions: Preoperative CAR, NLR, and PLR levels are valuable biomarkers for predicting early complications following PEG. Notably, higher CAR levels are significantly associated with increased complication risk. Incorporating these indicators into clinical decision-making could facilitate early identification of high-risk patients and implementation of preventive strategies.

Graphical Abstract

1. Introduction

Percutaneous endoscopic gastrostomy (PEG) is a widely utilized minimally invasive technique for providing long-term enteral nutrition in patients unable to meet their nutritional requirements orally [1,2]. First introduced by Gauderer et al. in 1980, the PEG procedure has become the standard approach for nutritional support, particularly in cases of neurological dysphagia and head and neck malignancies, owing to technical refinements and expanded indications [1,3]. Although generally considered safe, PEG is not without a substantial risk of complications. Reported complication rates in the literature range from 13% to 40% [3,4]. The most common minor complications include peristomal infection, subcutaneous leakage, tube blockage, and minor bleeding; major complications such as aspiration pneumonia, peritonitis, significant hemorrhage, and buried bumper syndrome, though less frequent, can also occur [4].
Post-procedural mortality is notably high among elderly patients with multiple comorbidities. Several cohort studies have reported 30-day mortality rates of 15–20%, with one-year mortality exceeding 50% in hospitalized geriatric PEG populations [5,6]. This highlights the necessity of thorough pre-procedural risk assessment and prediction of potential adverse outcomes. Various risk factors contributing to unfavorable PEG outcomes have been explored in prior research. Older age, low body mass index (BMI), and the presence of diabetes mellitus have all been associated with increased early postoperative mortality [7]. Indicators of malnutrition, such as low serum albumin levels, have similarly been linked to heightened complication and mortality risks [8]. In particular, a combination of serum albumin < 3 g/dL and CRP > 10 mg/L has been shown to significantly increase short-term mortality following PEG [9,10].
Recent studies have highlighted the diagnostic and prognostic significance of CBC-derived inflammatory markers in acute abdominal conditions, such as appendicitis and ovarian torsion, across both pediatric and adult populations [11,12,13,14]. Furthermore, these markers have shown substantial relevance in oncology settings and in patients suffering from malnutrition or chronic inflammation [15,16].
Elevated CRP levels, indicative of systemic inflammation, have been identified as independent predictors of early mortality in PEG recipients. Furthermore, conditions such as thrombocytopenia may impair wound healing, thereby elevating the risk of peristomal infections [10,17,18]. Taken together, these findings suggest that composite biomarkers reflecting both inflammation and nutritional status may offer enhanced prognostic value for adverse PEG outcomes.
In recent years, blood cell count-based inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have garnered attention as predictive and prognostic markers across various diseases. These parameters reflect the interplay between systemic inflammation and immune response and have been associated with poor prognosis in malignancies and critically ill populations [19]. For instance, elevated preoperative NLR values have been correlated with increased postoperative complication rates in patients undergoing esophageal cancer surgery [20]. Similarly, elevated NLR and PLR have been linked to wound infections and sepsis in patients undergoing major oncologic surgeries [21]. Due to their accessibility and cost-effectiveness, these markers hold promise for risk stratification and guiding preventive measures. However, data regarding their prognostic utility in PEG populations remains limited.
The CRP-to-albumin ratio (CAR), which combines inflammatory and nutritional parameters, has demonstrated strong predictive power for mortality in sepsis and critically ill patients [9,10]. CAR has also outperformed CRP alone in predicting postoperative complications in certain surgical cohorts [18]. Despite its potential, studies assessing the utility of CAR in PEG recipients are scarce. A 2021 study by Duzenli et al. reported that elevated preoperative CAR significantly increased the 30-day risk of mortality and complications following PEG [22]. Similarly, CAR was found to be an important prognostic marker in ICU patients undergoing PEG in a separate study [21]. Nevertheless, the impact of NLR and PLR on PEG outcomes remains unclear due to limited and inconsistent evidence.
This study aims to evaluate the predictive value of CAR, NLR, and PLR for early postoperative complications in patients undergoing PEG. By identifying high-risk individuals in the preoperative period, the goal is to enhance procedural safety through the timely implementation of preventive strategies.

2. Materials and Methods

2.1. Study Design and Patient Selection

This retrospective study analyzed medical records of 184 patients who underwent percutaneous endoscopic gastrostomy (PEG) between January 2021 and May 2022 at the General Surgery Department of Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital. Ethical approval was obtained from the Amasya University Ethics Committee (Approval No: E-30640013-050.04-246747). Inclusion criteria were patients over 18 years of age who had undergone endoscopic PEG placement. Patients were excluded if they had a history of gastric surgery, underwent PEG placement during active infection or sepsis, had missing clinical data, or had terminal conditions with a life expectancy of less than 30 days. All patients who underwent PEG during the study period were reviewed, and a total of 184 patients who met the inclusion and exclusion criteria were included in the final analysis.

2.2. Data Collection

Demographic data (age, gender), body mass index (BMI), and Charlson Comorbidity Index were recorded. Indications for PEG were categorized into neurological dysphagia (e.g., stroke, dementia), head and neck malignancies, and other causes (e.g., esophageal stricture, chronic eating disorders). Laboratory parameters included complete blood count and biochemical markers such as neutrophil, lymphocyte, platelet counts, C-reactive protein (CRP), and albumin levels. The neutrophil-to-lymphocyte ratio (NLR) is calculated as the neutrophil count divided by the lymphocyte count, the platelet-to-lymphocyte ratio (PLR) is the platelet count divided by the lymphocyte count, and the CRP-to-albumin ratio (CAR) is the CRP (mg/L) count divided by the albumin count (g/dL). Complications occurring within the first 30 days after the PEG procedure were defined as “early complications”.

2.3. Definitions and Assessments

Post-PEG complications were classified as either minor or major. Minor complications included peristomal skin infection, leakage at the PEG site, tube occlusion, and minor bleeding. Major complications included aspiration pneumonia, massive gastrointestinal bleeding, peritonitis, and buried bumper syndrome. The occurrence of any minor or major complication was referred to as “complication present”.

2.4. Statistical Analysis

Data were analyzed using IBM SPSS Statistics version 25.0 (IBM Corp., Armonk, NY, USA). The distribution of continuous variables was assessed using the Shapiro–Wilk test. Since the data were normally distributed, the Student’s t-test and appropriate statistical methods were applied. Continuous variables were expressed as mean ± standard deviation, and categorical variables as frequencies and percentages. Independent-sample t-tests were used for normally distributed continuous data, and Chi-square tests were used for categorical variables. A p-value of <0.05 was considered statistically significant. Multivariate logistic regression analysis was conducted to identify independent predictors of complications. The model included demographic factors such as age, gender, BMI, and Charlson Index, along with laboratory parameters CAR, NLR, and PLR. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). In our study, univariate analysis was initially performed, and variables with a p-value of ≤0.025 were selected for inclusion in the multivariate analysis. The variables included in the regression model, presented in Table 1, reflect those identified as statistically significant in the univariate analysis, based on this predefined selection criterion.

3. Results

Among the 184 patients included in the study, 108 (58.7%) were male and 76 (41.3%) were female. The patients’ ages ranged from 62 to 81 years, with a mean age of 71.5 ± 5.9 years. Regarding PEG indications, 54.3% (n = 100) had neurological dysphagia due to stroke, ALS, or dementia; 21.7% (n = 40) presented with obstructive dysphagia or radiation-induced swallowing difficulties related to head and neck malignancies; and 23.9% (n = 44) fell into the “other” category, including patients unable to take oral intake due to maxillofacial trauma sequelae or chronic critical illness.
Early complications were observed in 26 patients (14.1%). The most common complication was peristomal infection at the PEG site, occurring in 17 patients and diagnosed based on erythema, discharge, and positive culture results. Other complications included aspiration pneumonia (n = 3), gastrointestinal bleeding (n = 2), tube occlusion (n = 2), accidental tube dislodgement (n = 1), and peritonitis (n = 1). No cases of buried bumper syndrome were identified. The early (within 30 days) mortality rate was 12.0% (n = 22), with the majority of deaths (n = 19) attributed to the progression of the underlying disease. PEG-related mortality was calculated as 1.6% (n = 3), all due to aspiration pneumonia.
A comparison of the demographic, clinical, and laboratory data between patients with and without complications is presented in Table 2. There were no statistically significant differences in mean age (71.6 ± 5.9 years vs. 70.9 ± 5.9 years), gender distribution (59% male vs. 53.8% male), or BMI (22.9 ± 2.2 vs. 23.2 ± 1.6) between the groups (all p > 0.05). Similarly, the Charlson Comorbidity Index did not differ significantly (5.56 ± 1.07 vs. 5.38 ± 1.13; p = 0.56). These findings suggest that basic demographic parameters and comorbidity burden were not major determinants of complication development. The distribution of PEG indications (neurological, malignant, or other) also did not differ significantly between groups (p = 0.84) Figure 1.
On the other hand, laboratory analyses revealed significantly elevated inflammatory marker levels among patients who experienced complications.
In the non-complication group, the mean serum albumin level was 2.85 ± 0.31 g/dL, whereas it was slightly lower at 2.78 ± 0.35 g/dL in the group with complications. Although this difference was not statistically significant, a downward trend in albumin levels was observed among those who developed complications (p = 0.29). Regarding CRP levels, the mean value was 53.5 ± 35.3 mg/L in the complication group compared to 60.1 ± 30.7 mg/L in the non-complication group, with no significant difference (p = 0.54) (Table 2). The mean CRP/albumin ratio (CAR) was 0.62 ± 0.16 in patients without complications, whereas it was significantly higher in those with complications (1.89 ± 0.44, p < 0.001). Similarly, the mean neutrophil-to-lymphocyte ratio (NLR) was 5.56 ± 1.10 in the complication group, significantly higher than the 4.61 ± 1.13 observed in the non-complication group (p < 0.001). For the platelet-to-lymphocyte ratio (PLR), the average value was 231 ± 43.5 in patients with complications and 187 ± 34.9 in those without (p < 0.001).
The results of multivariate logistic regression analysis are presented in Table 1. Variables including age, gender, Charlson Comorbidity Index, PEG indication, CAR, NLR, and PLR were included in the model. The analysis identified elevated CAR levels as the strongest independent predictor of early post-PEG complications (OR: 2.88, 95% CI: 1.62–5.13; p < 0.001). Although increased NLR was associated with a higher likelihood of complications (OR: 1.34 per unit increase), its effect did not remain statistically significant in the multivariable model when adjusted for CAR (p = 0.08). PLR showed a borderline effect (OR: 1.02; p = 0.06). These findings suggest a potential collinearity between CAR and the other inflammatory markers, with CAR possibly capturing most of the predictive value of NLR and PLR. Demographic factors such as age and Charlson index did not independently predict complication risk (p = 0.60 and p = 0.52, respectively). Gender and PEG indication were also not significant in the multivariate model.
The above figure visualizes the odds ratios (OR) of variables associated with the risk of early complications following PEG. Notably, CAR (2.88) demonstrates a strong association with increased risk. The vertical reference line at OR = 1 indicates the point of no effect; values above or below this threshold represent increased or decreased risk.The above figure illustrates the percentage distribution of PEG indications (neurological, malignancy, and other) according to the presence or absence of complications. Neurological indication emerges as the most common cause in both groups.

4. Discussion

In this study, we evaluated the predictive role of preoperative inflammatory markers—namely, the C-reactive protein to albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—in the development of early complications following percutaneous endoscopic gastrostomy (PEG). Our findings demonstrated that elevated CAR was significantly associated with a higher incidence of post-PEG complications. Similarly, patients who experienced complications exhibited markedly higher levels of NLR and PLR. These results underscore the significance of systemic inflammation and immuno-nutritional status as key determinants in PEG outcomes [16].
The observed complication rate in our cohort was 14.1%, which falls near the lower end of the 13–43% range reported in the literature, supporting the overall safety profile of PEG [3,4]. Previous studies have reported complication rates of 13% and approximately 22%, as seen in the work by Figueiredo et al. and Lee et al., respectively [3,23]. The relatively low rate in our series may be attributable to the procedures being performed by an experienced surgical team and the routine administration of prophylactic antibiotics. Our early mortality rate of 12% aligns with or slightly undercuts rates reported elsewhere. Notably, several studies have shown that 30-day mortality following PEG can range between 15% and 25% among elderly patients or those with severe dysphagia [5,7,24]. It is plausible that careful application of inclusion criteria and the exclusion of terminal-stage patients contributed to the lower mortality in our study. Guidelines from both ESPEN and ESGE advise against PEG placement in patients with a life expectancy under one month [25], and our results lend further support to this recommendation, highlighting the importance of comprehensive pre-procedural assessment.
Among our most compelling findings was the strong association between CAR and the incidence of complications. Originally proposed as a prognostic marker in sepsis and critically ill patients, elevated CAR has been correlated with increased morbidity and mortality across multiple contexts [9,10]. One of the first studies to emphasize the value of CAR in predicting 30-day mortality and complications after PEG was conducted by Duzenli et al. in 2021 [26]. Our research further extends this evidence by demonstrating CAR’s capacity to predict not only mortality but also early minor and major complications. As a compound marker reflecting both inflammation (via CRP) and malnutrition (via hypoalbuminemia), CAR offers superior prognostic value compared to either parameter alone [13]. Notably, while isolated CRP and albumin levels did not significantly differentiate outcomes in our cohort, CAR produced a pronounced stratification. This finding aligns with studies in major abdominal surgery populations, where CAR outperformed CRP alone in predicting postoperative complications [18]. These findings suggest CAR may serve as a valuable tool for risk stratification in PEG candidates.
NLR and PLR are simple yet robust inflammatory indices with well-documented prognostic significance in oncology and critical care settings [19]. In our study, both markers were significantly elevated in patients with complications. This may reflect impaired wound healing or inadequate immune response due to heightened systemic inflammation. Neutrophilia typically indicates active inflammation, while lymphopenia reflects immune suppression; thus, an elevated NLR may point to increased susceptibility to infection-related complications [13,19]. Literature supports the use of NLR in predicting infectious complications in surgical patients [20,21], and our findings affirm this association, particularly in cases of post-PEG infection and peritonitis. PLR exhibited a similar pattern, being higher in the complication group. Elevated PLR suggests thrombocytosis with concurrent lymphopenia, a profile frequently observed in malignancy-associated inflammation or tissue damage [16,26]. A subset of our patients had PEG indications related to head and neck cancer, potentially explaining the heightened PLR due to stronger inflammatory responses. Interestingly, some studies have identified low PLR as a risk factor for peristomal leakage post-PEG [27]. For instance, Aziret et al. linked low PLR—possibly due to thrombocytopenia—to impaired wound healing and increased leakage risk. In contrast, our study focused more on infectious and general complications, and we found high PLR to be associated with increased risk. This apparent discrepancy may stem from the differing pathophysiological mechanisms underlying various complication types; while thrombocytopenia may predispose to wound dehiscence and leakage, excessive thrombocytosis and inflammation may facilitate infection. Therefore, optimal interpretation of NLR and PLR values requires contextual consideration of the clinical scenario.
Our findings regarding the predictive utility of preoperative inflammation and nutritional status are consistent with previous reports. Studies involving large patient cohorts have shown that advanced age, elevated CRP, and low albumin levels are significant predictors of early mortality following PEG [7,8,9]. In a study of 787 patients by Zopf et al., the 30-day mortality risk was significantly elevated in elderly, diabetic patients with low BMI; the combination of these three factors identified high-risk individuals with 80% sensitivity [7]. Similarly, our study found that when a high inflammatory burden (elevated CRP, lymphopenia) coincided with malnutrition (hypoalbuminemia), the risk of complications increased markedly. Hence, objective preoperative assessment of systemic health is crucial. Although indices such as the Charlson Comorbidity Index offer a general overview of chronic disease burden, we found no significant association between Charlson scores and complication rates. This may be because the index is more reflective of long-term mortality [28], whereas acute-phase reactants and blood-derived ratios such as CAR, NLR, and PLR appear to be more sensitive indicators of short-term postoperative outcomes. This observation is supported in the literature, where elevated CRP has been identified as the most important predictor of 30-day mortality following PEG in some studies. Given that high CRP and lymphopenia may also signal immune deficiency, they are likely markers of infection susceptibility. The predominantly infectious nature of complications in our cohort (e.g., peristomal infection, aspiration pneumonia) provides a plausible explanation for why these inflammatory markers emerged as significant risk factors.
Based on our results, preoperative assessment of CAR, NLR, and PLR may help delineate patient risk profiles prior to PEG placement. In particular, patients with CAR ≥ 1.1 appear to be at elevated risk for adverse events and may benefit from tailored preventative strategies. These could include aggressive management of existing infections, nutritional optimization, meticulous sterile technique during the procedure, and intensified postoperative surveillance. Indeed, large-scale studies and meta-analyses have emphasized the value of prophylactic antibiotic use and aseptic technique in reducing peristomal infection risk [29,30,31]. In our institution, a single pre-procedural dose of ceftriaxone is routinely administered, which aligns with best practices and has demonstrably lowered stoma infection rates [29]. Moreover, PEG outcomes may be improved through a multidisciplinary approach involving nutritionists, nurses, gastroenterologists, and surgeons [32,33,34]. Proper patient preparation, appropriate technique selection, and standardized post-procedural care protocols all contribute to procedural success [32,33,35,36]. Although the endoscopic “pull” method remains the most commonly employed PEG technique, radiological or surgical alternatives may be suitable in selected cases. Comparative studies have shown that all three methods yield similar complication rates when appropriately indicated and technically well-executed [37,38]. As our study focused exclusively on the endoscopic approach, future research could explore whether inflammatory markers also have predictive value in alternative PEG methods.
This study has some limitations. Being single-centered with a relatively small sample size, our findings should be interpreted cautiously in terms of generalizability. The statistical power may be limited, especially for rare major complications. Nonetheless, the retrospective study and homogeneity of the study population strengthen the internal validity of the results. Additionally, nutritional status was assessed solely via albumin levels, without inclusion of more comprehensive indices such as the Prognostic Nutritional Index. Future studies could benefit from comparing CAR alongside such tools. Despite these limitations, our findings clearly demonstrate that simple, easily measurable markers can provide valuable insight into risk stratification and outcome prediction in PEG patients. In our study, more complex composite inflammatory indices such as the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI) were not included. The primary reason for this exclusion is that certain variables required to calculate these indices, such as monocyte count, were not retrospectively available for all patients. However, we strongly believe that these indices should be investigated in future large-scale, multicenter, prospective studies.

5. Conclusions

Preoperative inflammatory markers appear to be significant predictors of post-procedural complications in patients undergoing percutaneous endoscopic gastrostomy (PEG). In particular, an elevated C-reactive protein-to-albumin ratio (CAR) is strongly associated with an increased risk of infections and other complications within the first 30 days following PEG placement. Similarly, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) reflect underlying inflammatory status and may aid in identifying patients at higher risk. The incorporation of these simple and cost-effective markers into routine preoperative assessments may allow for the early identification of high-risk individuals, thereby facilitating enhanced perioperative strategies. For instance, implementing intensified prophylactic measures and closer postoperative monitoring in patients with elevated CAR values could potentially reduce complication rates. In conclusion, preoperative inflammatory and immunonutritional indicators play a critical role in shaping early post-PEG outcomes and should be considered an integral part of clinical decision-making.

Author Contributions

S.E. and S.C. contributed to the conceptualization and design of the study. Data collection was carried out by S.E., while statistical analysis and interpretation were performed by S.C. Both authors drafted the manuscript and contributed to critical revisions. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was approved by the Clinical Research Ethics Committee of Amasya University (Approval number: E-30640013-050.04-246747, 24 February 2025). Written informed consent was obtained from all patients or their legal representatives after a detailed explanation of the study protocol and the PEG procedure. The study was conducted in accordance with the Declaration of Helsinki.

Informed Consent Statement

Informed consent was obtained from all individuals who participated in the study.

Data Availability Statement

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Acknowledgments

We would like to thank all the patients who participated in the study and the staff of the endoscopy unit for their contributions to the PEG procedures.

Conflicts of Interest

The authors declare no conflicts of interest. The supporting organizations had no role in the design of the study; the collection, analysis, or interpretation of data; the writing of the manuscript; or the decision to publish the results.

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Complications 02 00016 g001
Figure 1. Distribution of PEG indications by complication status.
Figure 1. Distribution of PEG indications by complication status.
Complications 02 00016 g001
Table 1. Logistic regression analysis results for early complication predictors.
Table 1. Logistic regression analysis results for early complication predictors.
VariableOR (Odds Ratio)95% Confidence Intervalp-Value
CAR2.881.62–5.13<0.001
NLR1.340.96–1.870.08
PLR1.021.01–1.420.06
Age0.970.89–1.050.60
Charlson Comorbidity Index0.910.68–1.230.52
Sex (Male)1.180.52–2.670.69
Indication (Malignancy)0.850.28–2.540.77
Indication (Other)0.920.31–2.740.88
The findings of the regression analysis underscore the significant impact of preoperative inflammatory and nutritional parameters—particularly the CAR value—on the development of post-PEG complications (Table 1).
Table 2. Characteristics of patients with and without complications (mean ± SD or n, %).
Table 2. Characteristics of patients with and without complications (mean ± SD or n, %).
VariableNo Complication (n = 158)With Complication (n = 26)p-Value
Age (years)71.6 ± 5.970.9 ± 5.90.54
Gender (Male/Female)94 (59.5%)/64 (40.5%)14 (53.8%)/12 (46.2%)0.67
Body Mass Index (kg/m2)22.9 ± 2.223.2 ± 1.60.52
Charlson Comorbidity Index5.56 ± 1.075.38 ± 1.130.48
PEG Indication—Neurological85 (53.8%)15 (57.7%)0.93 1
PEG Indication—Malignancy35 (22.2%)5 (19.2%)
PEG Indication—Other38 (24.0%)6 (23.1%)
Albumin (g/dL)2.85 ± 0.312.78 ± 0.350.29
CRP (mg/L)60.1 ± 30.753.5 ± 35.30.54
CRP/Albumin Ratio (CAR)0.62 ± 0.161.89 ± 0.44<0.001
Neutrophil-to-Lymphocyte Ratio4.61 ± 1.135.56 ± 1.10<0.001
Platelet-to-Lymphocyte Ratio186.7 ± 34.9231.3 ± 43.5<0.001
Note: 1 General p-value for PEG indication categories (Chi-square test). CRP: C-reactive protein; Alb: Albumin.
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Evirgen, S.; Cetin, S. The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG. Complications 2025, 2, 16. https://doi.org/10.3390/complications2030016

AMA Style

Evirgen S, Cetin S. The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG. Complications. 2025; 2(3):16. https://doi.org/10.3390/complications2030016

Chicago/Turabian Style

Evirgen, Suat, and Sirin Cetin. 2025. "The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG" Complications 2, no. 3: 16. https://doi.org/10.3390/complications2030016

APA Style

Evirgen, S., & Cetin, S. (2025). The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG. Complications, 2(3), 16. https://doi.org/10.3390/complications2030016

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