Preoperative neutrophil–lymphocyte ratio, an independent risk factor for postoperative cognitive dysfunction in elderly patients with gastric cancer

Abstract

This study aimed to investigate the potential risk factors for postoperative cognitive dysfunction (POCD) in elderly patients with gastric cancer (GC) after radical gastrectomy. Methods: In total, 221 elderly patients with GC who were scheduled to undergo selective radical gastrectomy in our hospital were enrolled in this study. To define early POCD, the neuropsychological assessment was carried out 1 day before surgery and 7 days after surgery. Receiver operating characteristic curve analysis was carried out to evaluate the predicative and cutoff values of risk factors, including neutrophil-lymphocyte ratio (NLR) for early POCD. The univariate and multivariate logistic regression analyses were performed to investigate risk factors for early POCD. Results: Of the 221 enrolled elderly patients with GC, 42 were identified as early POCD with an incidence of 19.0% (42 of 221). Receiver operating characteristic curve analysis indicated that NLR was a significant predictor for POCD with a cutoff value of 2.50 and an area under the curve of 0.711 (95% confidence interval: 0.624-0.798, P < 0.001). Preoperative NLR (≥2.50) was the only independent risk factor associated with POCD (odds ratio: 2.44, 95% confidence interval: 1.52-3.68, P = 0.013) by the multivariate logistic regression analysis. Conclusions: Preoperative NLR level was an independent risk factor for POCD in elderly patients with GC undergoing curative resection.

Th1, Th2, and Th17 cells and their corresponding cytokines are associated with anxiety, depression, and cognitive impairment in elderly gastric cancer patients

“…In addition, the prevalence of anxiety, depression, and cognitive impairment in elderly gastric cancer patients deserves further confirmation. The current study showed that 42%, 33%, and 19.9% of elderly gastric cancer patients had anxiety, depression, and cognitive impairment, which was similar to some of the previous studies ( 22 , 23 ). In addition, the prevalence of anxiety, depression, and cognitive impairment was increased in elderly gastric cancer patients compared to elderly normal individuals.…”

Risk factors and predictive value of perioperative neurocognitive disorders in elderly patients with gastrointestinal tumors

“…Our study revealed that perioperative pain management and infection control may be an important link to avoid the occurrence of PNDS. Interestingly, Halazun et al [ 26 ] and Yong, R. et al [ 27 ] have also reported the predictive role of preoperative NLR for POCD. However, the cut-off value of NLR for POCD in their results were 5.0 and 2.5, which was quite different from our study (2.0).…”

Preoperative laboratory testing in elderly patients

“…The ratio of neutrophils to lymphocytes was readily calculated from blood examination. Yong et al reported that POCD was observed in 19% of 221 elderly patients (≥65 years), and preoperative neutrophil-lymphocyte ratio (NLR) (cut-off value, ≥2.50) was a risk factor for POCD (OR 2.44, 95% CI 1.52–3.68; P = 0.013) [ 13 ]. Moreover, NLR can be readily obtained from the results of a standard complete blood examination.…”