Neutrophil to lymphocyte ratio and mortality in spinal epidural abscess

Karhade, Aditya V.; Shah, Kush C.; Shah, Akash; Nelson, Sandra; Schwab, Joseph H.

doi:10.1016/j.spinee.2019.02.005

Cited by 19 publications

(15 citation statements)

References 29 publications

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“…The decrease in peripheral lymphocyte count may be caused by apoptosis, which reflects the dysfunction of the immune system. In systemic inflammation, the increase in neutrophil count is accompanied by a corresponding decrease in the lymphocyte count 35 . This is consistent with our findings showing that the absolute lymphocyte count in patients with AS was lower than in healthy controls.…”

Section: Discussionsupporting

confidence: 93%

“…In systemic inflammation, the increase in neutrophil count is accompanied by a corresponding decrease in the lymphocyte count. 35 This is consistent with our findings showing that the absolute lymphocyte count in patients with AS was lower than in healthy controls. In conclusion, this study showed that the SII was elevated in patients with AS to both healthy controls and other patients in the remission stage and was positively correlated with disease activity.…”

Section: Ta B L E 3 Correlations Of Sii With Crp Esr and Basdai In As Patientssupporting

confidence: 93%

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Systemic immune‐inflammation index is associated with disease activity in patients with ankylosing spondylitis

Yan

Chai

2021

Clinical Laboratory Analysis

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Section: Discussionsupporting

confidence: 93%

Section: Ta B L E 3 Correlations Of Sii With Crp Esr and Basdai In As Patientssupporting

confidence: 93%

Systemic immune‐inflammation index is associated with disease activity in patients with ankylosing spondylitis

Yan

Chai

2021

Clinical Laboratory Analysis

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“…5,7-12 Numerous studies have highlighted salient sociodemographic and clinical characteristics, with more recent endeavors focusing on predictive modeling and the role of biomarkers. 9,11 Some of these measures can be complex to implement and understand while others may lack generalizability. The ideal informative measure can be easily ascertained across all patients with SEA and would be informative of disease severity at presentations and outcomes.…”

Section: Discussionmentioning

confidence: 99%

C-reactive Protein-to-albumin Ratio in Spinal Epidural Abscess: Association with Post-treatment Complications

Lindsey

Xiong

Lightsey

et al. 2022

J Am Acad Orthop Surg

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Introduction:Spinal epidural abscess (SEA) is a complex medical condition with high morbidity and healthcare costs. Clinical presentation and laboratory data may have prognostic value in forecasting morbidity and mortality. C-reactive protein-to-albumin ratio (CAR) demonstrates promise for the prediction of adverse events in multiple orthopaedic and nonorthopaedic surgical conditions. We investigated the relationship between CAR and outcomes after treatment of SEA.Methods:We retrospectively evaluated adult patients treated within a single healthcare system for a diagnosis of SEA (2005 to 2017). Laboratory and clinical data included age at diagnosis, sex, race, body mass index, smoking status, history of intravenous drug use, Charlson Comorbidity Index, and CAR. The primary outcome was the occurrence of any complication; mortality and readmissions were considered secondarily. We used logistic regression to determine the association between baseline CAR and outcomes, adjusting for confounders.Results:We included 362 patients with a 90-day mortality rate of 13.3% and a 90-day complication rate of 47.8%. A reduced complication rate was observed in the lowest decile of CAR values compared with the remaining 90% of patients, a threshold value of 2.5 (27.0% versus 50.2%; odds ratio [OR] 2.66, 95% confidence interval [CI] 1.22 to 5.81). CAR values in the highest two deciles experienced significantly increased odds of complications compared with the lowest decile (80th: OR 3.44; 95% CI 1.25 to 9.42; 90th: OR 3.28; 95% CI 1.19 to 9.04).Discussion:We found elevated CAR to be associated with an increased likelihood of major morbidity in SEA. We suggest using a CAR value of 2.5 as a threshold for enhanced surveillance and recognizing patients with values above 73.7 as being at exceptional risk of morbidity.Level of Evidence:Level III observational cohort study.

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“…Karhade ve ark. (29) tarafından yapılmış olan başka bir çalışmada, spinal epidural apse hastalarında 90 günlük mortalitede NLO'nun bağımsız bir risk faktörü olduğu öne sürülmüş ve artmış TLO'nun advers kardiyovasküler olaylar ile ilişkili olduğu gösterilmiştir (5) . Emektar ve ark.…”

Section: Discussionunclassified

Can High Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios at Presentation Predict Sustained Elevation of CRP Levels in Pediatric Patients with Septic Arthritis?

Ergin¹,

Koç²,

Özmen³

2021

IKSST

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INTRODUCTION: Septic arthritis is a surgical emergency that can result in significant morbidity if not treated promptly and appropriately. With appropriate surgical and antibiotic therapy, inflammatory markers are expected to rapidly normalize in the patients with septic arthritis. Lack of or slow normalization may signify treatment failure. Our aim was to investigate if high neutrophil-lymphocyte and platelet-lymphocyte values can be used to predict sustained elevation of CRP levels. METHODS: Fifty-seven pediatric patients operated in our clinic with the diagnosis of septis athritis between 2003 and 2016 were included in the study. Neutrophil, lymphocyte and platelet counts as well as CRP and ESR values at presentation, 1 and 2 weeks were scanned Neutrophil-lymphocyte and platelet-lymphocyte values were calculated. RESULTS: Average age of the patients were 7 years (1 month-16 years).Of the 57 patients 41 were male (71.9%) and 16 were female (28.1%).The knee was the affected joint in 38 cases (66.7%) and hip in 19 cases (33.3%). Left and right sides were affected in 29 (50.9%) cases and in 28 cases (49.1%), respectively.Average neutrophil count at presentation was (1,1-34,9), platelet 425,7 (31-830) and lymphocyte 3.1 (0,1-9,8).CRP at 14 days was on average 38 (3-164) mg/dL. ROC curve analysis showed that a threshold level of neutrophil-lymphocyte>4,3 at presentation is 71% sensitive and 70%spesific for CRP levels >20 mg/L at 2 weeks. DISCUSSION AND CONCLUSION: A threshold of neutrophil-lymphocyte ratio of >4.3 at presentation is fairly sensitive and specific for prediction of CRP levels above >20 mg/L at 2 weeks. Possibility of slow normalization and even persistence of higher levels of CRP, in this patient group should be kept in mind.

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Neutrophil to lymphocyte ratio and mortality in spinal epidural abscess

Cited by 19 publications

References 29 publications

Systemic immune‐inflammation index is associated with disease activity in patients with ankylosing spondylitis

Systemic immune‐inflammation index is associated with disease activity in patients with ankylosing spondylitis

C-reactive Protein-to-albumin Ratio in Spinal Epidural Abscess: Association with Post-treatment Complications

Can High Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios at Presentation Predict Sustained Elevation of CRP Levels in Pediatric Patients with Septic Arthritis?

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