The Effect of Bilirubin on Clinical Outcomes of Patients With Colorectal Cancer Surgery: A Ten-Year Volume Single-Center Retrospective Study

Abstract

The current study aimed to evaluate the effect of bilirubin on the outcomes of colorectal cancer (CRC) in patients who underwent radical CRC surgery. The levels of serum bilirubin, including total bilirubin (TBil), direct bilirubin (DBil) and indirect bilirubin (IBil), were divided into higher groups and lower groups according to the median. Multivariate logistic regression was performed to analyze the independent predictors for overall complications and major complications. For TBil, the hospitalization time of the higher TBil group was longer than that of the lower TBil group (p = 0.014 < 0.05). For DBil, the higher DBil group had longer operation times (p < 0.01), more intraoperative bleeding (p < 0.01), longer hospital stays (p < 0.01), and higher rates of overall complications (p < 0.01) and major complications (p = 0.021 < 0.05) than the lower DBil group. For the IBil group, blood loss during operation (p < 0.01) and hospital stays (p = 0.041 < 0.05) in the higher IBil group were lower than those in the lower IBil group. In terms of complications, we found that DBil was an independent predictor for overall complications (p < 0.01, OR = 1.036, 95% CI = 1.014–1.058) and major complications (p = 0.043, HR= 1.355, 95% CI= 1.009–1.820). Higher preoperative DBil increase the risk of complications after primary CRC surgery.

Acknowledgments

We acknowledge all the authors whose publications are referred to in our article, and we thank Xun Lei for the substantial work in the statistical methods.

Authors’ contributions

All authors contributed to data collection and analysis, drafting or revising the manuscript, have agreed on the journal to which the manuscript will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Competing interests

The authors declared no conflicts of interest in this study.

Data availability statement

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

Ethics approval and Informed Consent

The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University was obtained (2021-536), and informed consent was acquired from all patients.

Additional information

Funding

This study was supported by Chongqing key diseases Research and Application Demonstration Program (Colorectal Cancer Prevention and Treatment Technology Research and Application Demonstration [No. 2019ZX003]).