Neutrophil-to-Lymphocyte Ratio is a Useful Biomarker for Predicting Postoperative Complications in Crohn’s Disease

Tsunoda, Junya; Shigeta, Kohei; Matsui, Shimpei; Seishima, Ryo; Okabayashi, Koji; Kitagawa, Yuko

doi:10.1007/s11605-022-05270-8

Cited by 3 publications

(3 citation statements)

References 5 publications

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“… 21 Moreover, a higher level of NLR is associated with the occurrence of postoperative complications in CD. 10 , 22 Similarly, we demonstrated that a high level of NLR indicated a high risk of postoperative recurrence in CD patients with iAL. A potential interpretation of why a high level of NLR is associated with poor prognosis is that NLR is an indicator of a disordered immune system.…”

Section: Discussionsupporting

confidence: 62%

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Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions

Chen

Chao

et al. 2023

Therap Adv Gastroenterol

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Background: Patients with isolated anastomotic lesions (iAL) are common in postoperative Crohn’s disease (CD) and have heterogeneous prognosis. Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in CD patients with iAL. Design: A bicenter retrospective cohort study. Methods: CD patients who received ileocolonic resection from 2013 and 2020 and had a modified Rutgeerts score of i2a were recruited. NLR was determined within 1 week around the initial endoscopy after ileocolectomy. The primary outcome was clinical recurrence. Kaplan–Meier method and Cox hazard regression analysis were utilized to assess the association between candidate variables and outcomes of interest. Results: In total, 411 postoperative CD patients were preliminarily reviewed and 83 patients were eligible. In total, 36 (48.6%) patients experienced clinical recurrence with a median follow-up time of 16.3 (interquartile range, 9.7–26.3) months. NLR > 2.45 and age at surgery >45 years had higher cumulative incidence of clinical recurrence in the Kaplan–Meier analysis. After adjusted for potential confounders, NLR > 2.45 was the only independent risk factor for clinical recurrence, with an adjusted hazard ratio (HR) of 2.88 [95% confidence interval (CI), 1.39–6.00; p = 0.005]. Furthermore, a risk score based on NLR and age at surgery were built to further stratify patients. Compared to those who scored 0, patients with a score of 1 and 2 had an adjusted HR of 2.48 (95% CI, 1.22–5.02) and 6.97 (95% CI, 2.19–22.16) for developing clinical recurrence, respectively. Conclusions: NLR is a promising prognostic biomarker for CD patients with iAL. The utilization of NLR and the risk score to stratify patients may facilitate the personalized management in patients with iAL.

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Section: Discussionsupporting

confidence: 62%

“… 9 Moreover, NLR can predict postoperative complication in CD patients with intestinal resection. 10 However, it is still unknown whether NLR has prognostic value in postoperative CD patients with iAL.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions

Chen

Chao

et al. 2023

Therap Adv Gastroenterol

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“…NLR is one of the most accepted prognostic indices and has a positive correlation to disease severity, progress, and mortality, reflecting the immune system's sufficiency and its ability to "fight" inflammation. It is thus applicable to a variety of disease conditions, from carcinomas to inflammatory bowel and cardiovascular diseases [48][49][50][51][52][53]. In a recent study of ours on cardiac surgery patients, the NLR values on post-operative days 5 and 7 demonstrated significant discriminatory efficacy for predicting mortality within 90 days [54].…”

Section: Discussionmentioning

confidence: 87%

The Effect of Probiotics on the Prognostication of the Neutrophil-to-Lymphocyte Ratio in Severe Multi-Trauma Patients

Menni,

Tzikos,

Fyntanidou

et al. 2024

JPM

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Background: The ratio of neutrophils to lymphocytes [NLR] is one of the most accepted prognostic indices and demonstrates a positive correlation with the severity of a disease. Given that probiotics exerted immunomodulatory properties and thus positively affected lymphocytopenia induction in severely ill patients, we performed a post hoc analysis in the ProVAP protocol to investigate whether probiotics affected the prognostication of NLR in respect to ventilator-associated pneumonia in multi-trauma patients. This cohort mandatorily involved severe traumatic brain injury patients. Methods: The white blood cell data of all patients, after being retrieved for the days 0 and 7, were statistically assessed in respect to neutrophils, lymphocytes and NLR among the 4 sub-groups of the study: placebo/no-VAP, placebo/VAP, probiotics/no-VAP, and probiotics/VAP. Results: Lymphopenia was dominant in placebo sub-groups, while an increased level of lymphocytes was prominent in probiotics sub-groups. This resulted in an increase [p = 0.018] in the NLR value in the probiotics/VAP group in relation to the probiotics/no-VAP cohort; this was an increase of half the value of the placebo/VAP [p < 0.001], while the NLR value in placebo/no-VAP group increased almost four-fold in relation to probiotics/no-VAP [p < 0.001]. Additionally, the ROC curve for probiotic-treated patients revealed a NLR7 cut-off value of 7.20 as a prognostic factor of VAP (AUC: 78.6%, p = 0.015, 95% CI: 62.6–94.5%), having a high specificity of 90.2% and a sensitivity of 42.9%. Conclusions: NLR may considered a credible prognostic biomarker in multi-trauma patients since it can evaluate the immunomodulatory benefits of probiotic treatment. However, the results of the present post hoc analysis should be interpreted meticulously until further evaluation, since they may be basically species- or strain-specific.

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Are Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Lymphocyte-to-Monocyte Ratios Predictive of Postoperative Complications and Mortality in Patients with Inflammatory Bowel Disease?

Tuncer¹,

Tuncer²,

Aydogan³

et al. 2023

tjcd

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Neutrophil-to-Lymphocyte Ratio is a Useful Biomarker for Predicting Postoperative Complications in Crohn’s Disease

Cited by 3 publications

References 5 publications

Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions

Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn’s disease patients with isolated anastomotic lesions

The Effect of Probiotics on the Prognostication of the Neutrophil-to-Lymphocyte Ratio in Severe Multi-Trauma Patients

Are Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Lymphocyte-to-Monocyte Ratios Predictive of Postoperative Complications and Mortality in Patients with Inflammatory Bowel Disease?

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