Assessment of prognostic value of preoperative neutrophil-to-lymphocyte ratio for postoperative mortality and morbidity

Zhu, Yuanli; Bi, Yaodan; Liu, Bin; Zhu, Tong

doi:10.3389/fmed.2023.1102733

Cited by 8 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because high NLR might reflect an activated immune system and increased systemic inflammatory response, which contributes to worse outcomes by increasing intraoperative cytokines releasing harmful oxygen-derived free radicals with the addition of surgical stress (25)(26)(27). The fact that the VAS Scores found in the study were higher in patients with high NLR also supports this hypothesis.…”

Section: Discussionsupporting

confidence: 57%

Association of Hematologic Parameters with Post-operative Outcomes in Patients Undergoing Lumbar Disc Herniation Surgery

Bulduk,

Aksoğan

2023

Med Sci Discov

View full text Add to dashboard Cite

Objective: In this study, we aimed to determine whether hematologic parameters have an effect on the post-operative outcomes in patients operated for lumbar disc herniation. Material and Methods: The study was conducted in the retrospective cohort design in the Department of Neurosurgery of Ankara Güven Hospital and included patients who were hospitalized and treated with the diagnosis of Lumbar Disc Herniation (LDH) between 01.01.2019 and 31.12.2020. Patients' pre-operative hematologic parameters, which were routinely studied preoperatively, and Visual Analogue Scale (VAS) scoring records, which were routinely used to monitor pain levels, were retrospectively reviewed, and the outpatient clinic notes of the patients within 6 months post-operatively were evaluated. Results: Among 117 patients hospitalized with LDH over a 1-year period, 87 patients were included in the study. 30 LDH patients, owning factors that may affect wound healing and platelet function (active infection/diabetes mellitus, antiaggregants/anticoagulants) were excluded. When Hb was examined from the pre-operative hematological parameters, anemia was detected in 6 (7%) of 87 patients; however, it had no significant effects on VAS scores and surgical outcomes (p>0.05). Pre-operative Neutrophil-to-Lymphocyte Ratio (NLR) was elevated in 17 (20%) of the 87 patients, and the VAS score of these patients was found to be 1.5-fold higher than normal patients (p=0.031). Post-operative complications (infection, hemorrhage and cerebrospinal fluid fistula) were detected in 5 (6%) of the 87 patients who underwent surgery, and it was found that the pre-operative NLR values were high in these 5 patients. It was also found that high NLR increased the risk of post-operative complications 1.4-fold in patients (p=0.002). No results could be obtained regarding the platelet values because this parameter was within the normal range preoperatively in all patients. Conclusion: In the present study, the effects of hematological parameters on lumbar disc surgery were investigated, and it was concluded that elevated NLR values increased wound site infection among post-operative complications and VAS scores.

show abstract

Section: Discussionsupporting

confidence: 57%

Association of Hematologic Parameters with Post-operative Outcomes in Patients Undergoing Lumbar Disc Herniation Surgery

Bulduk,

Aksoğan

2023

Med Sci Discov

View full text Add to dashboard Cite

show abstract

“…Previous studies evaluated the prognostic value of NLR in hospitalized patients, mostly in speci c diseases or conditions (22)(23)(24). While a substantial agreement has been reached on the association between high NLR and poor outcomes, a high heterogeneity of the proposed cutoffs has been highlighted (22,(25)(26)(27). In our population, we observed a relatively high mean NLR of 9.5, which could be related to pre-existing comorbidities, most of which are accompanied by the chronic low-grade proin ammatory status that characterizes age-related diseases (28).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio (NLR) predicts mortality in hospitalized geriatric patients independent of the admission diagnosis: a multicenter prospective cohort study.

Rosa,

Sabbatinelli,

Soraci

et al. 2023

Preprint

View full text Add to dashboard Cite

Background The Neutrophil-to-lymphocyte ratio (NLR) is a marker of poor prognosis in hospitalized older patients with different diseases, but there is still no consensus on the optimal cut-off value to identify older patients at high-risk of in-hospital mortality. Therefore, in this study we aimed at both validating NLR as a predictor of death in older hospitalized patients and assess whether the presence of specific acute diseases can modify its predictive value.Methods this prospective cohort study included 5,034 hospitalizations of older patients admitted to acute care units in the context of the ReportAge study. NLR measured at admission was considered as the exposure variable, while in-hospital mortality was the outcome of the study. ROC curves with Youden’s method and restricted cubic splines were used to identify the optimal NLR cut-off of increased risk. Cox proportional hazard models, stratified analyses, and Kaplan-Meier survival curves were used to analyse the association between NLR and in-hospital mortality.Results both continuous and categorical NLR value (cut-off ≥ 7.95) predicted mortality in bivariate and multivariate prognostic models with a good predictive accuracy. The magnitude of this association was even higher in patients without sepsis, congestive heart failure, and pneumonia, and those with higher eGFR, albumin, and hemoglobin (p < 0.001). A negative multiplicative interaction was found between NLR and eGFR (p = 0.001).Conclusions NLR at admission is a readily available and cost-effective biomarker that could improve identification of geriatric patients at high risk of death during hospital stay independent of admitting diagnosis, kidney function and hemoglobin levels.

show abstract

“…The findings of this study are consistent with previous research that has shown that inflammation is a significant risk factor for prolonged LOS in patients undergoing orthopedic surgery. 37 Inflammation can lead to a number of complications such as infection, sepsis, and organ failure, all of which can contribute to a longer LOS. In line with our findings, we also observed that the median LOHS was significantly higher in patients with SII value ≥ 799.86 compared to those with lower SII value (<799.86).…”

Section: Discussionmentioning

confidence: 99%

The Value of Preoperative Systemic Immune-Inflammation Index as a Predictor of Prolonged Hospital Stay in Orthopedic Surgery: A Retrospective Study

Alsabani,

Alotaibi,

Olayan

et al. 2023

IJGM

View full text Add to dashboard Cite

Purpose Many risk factors, such as the duration of surgery and higher ASA scores, are associated with longer hospitalization in patients undergoing orthopedic surgery. However, no studies have evaluated the relationship between the preoperative systemic immune-inflammation index (SII) and length of hospital stay in orthopedic surgical patients. Therefore, this study aimed to investigate whether the SII is associated with the length of hospital stay in orthopedic surgery in adults. Patients and Methods This was a retrospective cohort study, and data were extracted from electronic health records. Patients were included if they were older than 18 years and had undergone orthopedic surgery between [2016–2021]. The patients were divided into two groups according to the median duration of hospitalization and according to SII cut-off value (high-SII group: ≥799.86, low-SII group: <799.86). Univariate and multivariate linear regression analyses were used to identify the association between SII and length of hospitalization. Results A total of 196 patients who underwent orthopedic surgery were included, and 62 were hospitalized for >21 days. There were significant differences in terms of ASA score ( P = 0.041). Patients who required a longer hospitalization of >21 days had significantly lower hemoglobin level ( P < 0.001), higher duration of surgery ( P = 0.015), and increased requirement of ICU admission ( P < 0.001). The optimal cut-off value for preoperative SII of 799.86 stratified the patients into high-SII and low-SII groups. Patients in high-SII group had higher median LOHS (22 days) compared to low-SII group (17 days; P = 0.006). In the multivariable linear regression analysis, the SII was significantly related to the length of hospital stay (β = 0.246, 95% confidence interval [CI] 0.000–0.005, P = 0.031). Conclusion A high-SII value is associated with an increased risk of longer hospitalization after orthopedic surgery.

show abstract

Assessment of prognostic value of preoperative neutrophil-to-lymphocyte ratio for postoperative mortality and morbidity

Cited by 8 publications

References 29 publications

Association of Hematologic Parameters with Post-operative Outcomes in Patients Undergoing Lumbar Disc Herniation Surgery

Association of Hematologic Parameters with Post-operative Outcomes in Patients Undergoing Lumbar Disc Herniation Surgery

Neutrophil-to-lymphocyte ratio (NLR) predicts mortality in hospitalized geriatric patients independent of the admission diagnosis: a multicenter prospective cohort study.

The Value of Preoperative Systemic Immune-Inflammation Index as a Predictor of Prolonged Hospital Stay in Orthopedic Surgery: A Retrospective Study

Contact Info

Product

Resources

About