Preoperative Neutrophil-lymphocyte Ratio Research Articles

Assessing the clinical utility of pre-operative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer.

There is a paucity of data supporting the role of neutrophil-lymphocyte ratios (NLR) to determine clinicopathological parameters in patients being treated for primary breast cancer. To evaluate the association between pre-operative NLR and clinicopathological parameters in patients diagnosed with breast cancer. A retrospective cohort study was performed. This included consecutive patients indicated to undergo surgery for primary breast cancer at University Hospital Limerick between January 2010 and June 2017. NLR was expressed as a continuous variable. Univariable and multivariable linear regression analyses were used to determine the correlation between NLR and clinicopathological data. Data analytics was performed using SPSS v29.0. 673 patients met the inclusion criteria. Overall, the median preoperative NLR is 2.63 (standard deviation: 1.42). At univariable analysis, patient age (beta coefficient: 0.009, 95% confidence interval (CI) 0.001-0.017, P = 0.027), tumour size (beta coefficient: 0.013, 95% CI 0.005-0.021, P = 0.001), and human epidermal growth factor receptor-2 status (beta coefficient: -0.370, 95% CI -0.676-0.065, P = 0.017) were all predicted using NLR. However, at multivariable analysis, tumour size was the sole parameter predictable by NLR (beta coefficient: 0.011, 95% CI 0.002-0.019, P = 0.013). This study demonstrates that pre-operative NLR may serve as an independent predictor of tumour size in patients being treated with primary breast cancer. Ratification of these preliminary findings is warranted before robustly adopted into clinical practice.

Pre-operative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as Predictors of Morbidity and Mortality in Diabetic Foot Infection Amputation Patients

Background: Diabetic foot infection is a complication of uncontrolled diabetes. Some cases require amputation to avoid the spread of infection; however, this can also lead to poor outcomes. Inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), have been explored as predictors of outcomes following amputation; however, only a few published studies are available. Objective: The study aimed to determine the diagnostic value of pre-operative neutrophil-lymphocyte and platelet-lymphocyte ratios in predicting in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation in a tertiary government hospital. Methodology: This retrospective cohort study included a total of 535 diabetic foot ulcer patients who underwent amputation at a tertiary government hospital. Data was collected via medical chart review. Complete blood count (CBC) parameters closest to the time of amputation were obtained to calculate the neutrophil-lymphocyte and platelet-lymphocyte ratios. Stata software was used for data processing and analysis. Results: Only 10.28% of patients experienced in-hospital morbidity and/or mortality. Based on Youden’s index, the optimal cutoff points of neutrophil-lymphocyte and platelet-lymphocyte ratios were 7.27 and 32.40, respectively. Both markers showed 98% sensitivity in predicting the outcome. Specificity was 99% for the neutrophil-lymphocyte ratio and 93% for the platelet-lymphocyte ratio. Accuracy parameters remained high when morbidity and mortality were analyzed separately, and subgroup analyses by major and minor amputations were performed. Conclusion: Neutrophil-lymphocyte and platelet-lymphocyte ratios accurately predict in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation. The low cost and wide availability of a CBC make NLR and PLR valuable options in low-resource settings. Future studies should explore these markers' utility in predicting long-term outcomes after amputation.

Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study

Abstract Background and Aims: Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS). Material and Methods: A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman’s rank correlation analysis. Results: The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12th, 24th and 48th h [(Spearman’s rank correlation coefficient), r = 0.462, P < 0.001; r = 0.519 P < 0.001; r = 0.455 P < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (P = 0.023). Conclusion: The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.

087. Relationship Between Neutrophil-Lymphocyte Ratio and Serum Thyroid Stimulating Hormone Preoperative Thyroidectomy as Predictors of Papillary Thyroid Cancer

Background: Thyroid cancer is the most common endocrine malignancy. The incidence of papillary thyroid cancer has been increasing. Early diagnosis and management are crucial for thyroid cancer. Therefore, the availability of predictive biomarkers for papillary thyroid cancer is important. This study aims to determine whether the preoperative Neutrophil-Lymphocyte Ratio (NLR) and Thyroid Stimulating Hormones (TSH) levels can be used as predictors of papillary thyroid cancer. Methods: Ninety-one patients with thyroid nodules who underwent thyroidectomy surgery at RSUP Prof. DR. R.D. Kandou were retrospectively analyzed. Complete blood count with differential count and serum TSH levels were taken before thyroidectomy. Results: The relationship between TSH levels and papillary thyroid cancer was significant, with a p-value of 0.025, sensitivity of 51.1%, and specificity of 73.9%. The relationship between NLR and papillary thyroid cancer was also significant, with a p-value of <0.001, sensitivity of 68.9%, and specificity of 100%. However, the combination of NLR and TSH did not show a synergistic effect as predictors of papillary thyroid cancer due to several unstudied factors, such as IL-6, IL-37, ROS, NO, and NK cells, which may play a role in the pathogenesis of thyroid cancer. The limitations of this study include its retrospective cross-sectional design and the lack of further investigation into other factors, such as IL-6, IL-37, ROS, NO, and NK cells, due to limited facilities and time. Conclusion: Both NLR and TSH can be used as predictors of papillary thyroid cancer. NLR is more potent than TSH as a predictor.

Predictive Value of Preoperative Peripheral Blood Inflammatory Markers for Surgical Site Infection in Laparoscopic Radical Gastrectomy for Gastric Cancer.

Background: To investigate the predictive value of preoperative peripheral blood inflammatory markers for surgical site infection (SSI) in laparoscopic radical gastrectomy for gastric cancer. Methods: A retrospective analysis was conducted on patients undergoing laparoscopic radical gastrectomy for gastric cancer, categorized into SSI and non-SSI groups based on postoperative SSI occurrences. Patient demographics, surgical details, laboratory results, and SSI incidence data were extracted. Differences in indicators, including neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and platelet-lymphocyte ratio (PLR), were assessed between the two groups. Multivariate logistic regression was utilized to determine the independent association of each indicator with SSI. Receiver operating characteristics (ROC) curve analysis was utilized to evaluate the predictive value of parameters. Results: Of 169 patients, 36 (21.30%) experienced SSI postoperatively. The SSI group exhibited higher preoperative NLR and SII (p < 0.05). After adjusting for variables, preoperative NLR (OR = 1.691, 95% CI: 1.211-2.417, p = 0.003) and SII (OR = 1.001, 95% CI: 1.000-1.002, p = 0.006) were identified as independent risk factors for SSI. Both NLR (AUC = 0.758, 95% CI: 0.666-0.850) and SII (AUC = 0.753, 95% CI: 0.660-0.850) demonstrated favorable diagnostic performance for predicting postoperative SSI. Conclusion: Preoperative NLR and SII significantly associate with postoperative SSI in laparoscopic radical gastrectomy for gastric cancer, making them valuable indicators for early prediction of SSI.

Utility of Neutrophil–lymphocyte Ratio and Platelet–lymphocyte Ratio in Predicting Malignancy in Patients with Small Renal Mass

ABSTRACT Background: Abdominal imaging has become increasingly prevalent, resulting in the incidental detection of renal tumors. The majority of small renal masses (SRMs), which are surgically removed, prove to be malignant. However, some cases turn out to be benign, which can lead to unnecessary surgeries with associated significant morbidity. Recently, many inflammatory biomarkers have shown to be promising prognostic factors in RCC. We aimed to assess the importance of inflammatory biomarkers, which are simple and economical, in SRMs. Objective: We investigated whether preoperative neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) can predict malignancy in patients with SRMs. Material and Methods: A retrospective analysis was performed on 108 patients who underwent partial or radical nephrectomy for SRMs (tumors smaller than 4 cm) from January 2016 to December 2022. The patients were classified into two groups based on their histopathological diagnosis: benign group (n = 28) and malignant group (n = 80). NLR and PLR values were assessed for sensitivity using the ROC curve. Independent t-test, Mann–Whitney test, and Chi-square test were utilized. P &lt;0.05 indicated statistical significance. Results: The mean age of patients was 58.9 ± 12.3 years in the benign group and 53.3 ± 11.9 years in the malignant group (P = 0.03). The mean tumor size was 3.26 ± 0.52 cm in the benign group and 3.04 ± 0.90 cm in the malignant group (P = 0.60). NLR (P = 0.008) and PLR (P ≤ 0.001) values were significantly higher in the malignant group (median: 3.65 and 201) compared to the benign group (median: 2.82 and 125), respectively. The area under a ROC curve was 0.669 (P = 0.002) and 0.758 (P &lt; 0.001), with sensitivity values of 62.5% and 87.5%, specificity of 64.29% and 57.14%, and cutoff points of 3.45 and 130.21, for NLR and PLR, respectively. Conclusion: NLR and PLR can be considered biomarkers for predicting malignancy in SRMs. NLR and PLR should be included in a patient’s clinical evaluation along with imaging studies and overall health status.

Association between Preoperative Neutrophil-lymphocyte Ratio and All-cause Mortality in Patients Treated with Thoracic Endovascular Aortic Repair for Degenerative Thoracic Aortic Aneurysm

The neutrophil-lymphocyte ratio (NLR) has been increasingly recognized as a reliable surrogate marker for predicting mortality in clinical practice. This study determined the predictive ability of NLR for overall mortality after thoracic endovascular aortic repair (TEVAR) for degenerative thoracic aortic aneurysm (TAA). Data from patients treated with TEVAR for degenerative TAA at our university hospital from January 2013 to December 2021 were evaluated. The preoperative NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. One hundred-three patients were included in this study. During a 9-year follow-up, 32 patients (31.1%) died. Multivariable analyses showed that age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.00-1.12; P=0.021), ischemic heart disease (HR, 2.13; 95% CI, 1.05-4.36; P=0.038), and NLR (HR, 1.36; 95% CI, 1.08-1.72; P=0.009) predicted all-cause mortality after TEVAR. A receiver operating characteristic curve determined the optimal cutoff value of NLR to predict all-cause mortality was 3.48. An elevated preoperative NLR is indicative of a higher likelihood of all-cause mortality in patients treated with TEVAR for degenerative TAA, suggesting that NLR could serve as a possible biomarker for stratifying patients at risk of overall mortality after TEVAR.

Neutrophil-Lymphocyte Ratio as a Predictor of Persistent Type 2 Endoleak after Endovascular Aneurysm Repair.

Objectives: One of the important postoperative complications of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is type 2 endoleak (T2EL). However, there is no well-established biomarker. We aimed to evaluate the validity of the neutrophil-lymphocyte ratio (NLR) as a predictor of T2EL. Methods: Data were retrospectively collected from 146 patients who underwent EVAR for AAA at our institution between April 1, 2008 and March 31, 2021. Within 90 days before surgery, preoperative NLR was calculated from the same blood sample. The receiver operating characteristic curve (ROC) was used to determine the cutoff NLR values for persistent T2EL. Univariate and multivariate analyses were performed. Results: Compared with patients without persistent T2EL, those who had persistent T2EL had lower preoperative NLR (P = 0.041), based on a cutoff value of 1.918, and the entire group was then divided into two groups based on these values for comparison. Univariate analysis showed significant differences in NLR, the white blood cell (WBC) count, the percentage of mural thrombus of aneurysm, history of the hypertension, follow-up term, and aneurysm diameter at final follow-up. Multivariate analysis showed that NLR and AAA diameter on the last follow-up were significantly associated with T2EL persistence. Conclusions: Preoperative low NLR can be a useful predictor of postoperative persistent T2EL.

The preoperative scoring system combining neutrophil/lymphocyte ratio and CA19-9 predicts the long-term prognosis of intrahepatic cholangiocarcinoma patients undergoing curative liver resection

BackgroundThis study aims to investigate preoperative prognostic factors available for intrahepatic cholangiocarcinoma (ICC) patients and propose a new preoperative prognostic scoring system for ICC that combines CA19-9 and neutrophil/lymphocyte ratio (NLR).MethodsIn this retrospective analysis, 1728 patients diagnosed with ICC and undergoing curative liver resections were studied. This study employed univariate and multivariate Cox regression to find factors affecting recurrence and overall survival (OS), and furthermore assessed how preoperative models influenced tumor traits and postoperative recurrence.ResultsThe results of the multivariate Cox regression analysis indicated that two preoperative variables, NLR and Ca19-9, were independent risk factors affecting postoperative recurrence and OS in ICC patients. Based on this data, assigning a score of 0 (NLR ≤ 2.4 and Ca19-9 ≤ 37U/ml) or 1 (NLR > 2.4 and Ca19-9 > 37U/ml) to these two factors, a preoperative prognostic score was derived. According to the scoring model, patients were divided into three groups: 0 points (low-risk group), 1 point (intermediate-risk group), and 2 points (high-risk group). The 5-year recurrence and OS rates for the three groups were 56.6%, 68.2%, 77.8%, and 56.8%, 40.6%, 27.6%, respectively, with all P values < 0.001. Furthermore, high-risk group patients were more prone to early recurrence (early recurrence rates for high-, intermediate-, and low-risk groups were 56.8%, 51.5%, and 37.1%, respectively, P < 0.001) and extrahepatic metastasis (extrahepatic metastasis rates for high-, intermediate-, and low-risk groups were 31.7%, 26.4%, and 15.4%, respectively, P < 0.001). In terms of tumor characteristics, high-risk group patients had larger tumor diameters and were more likely to experience microvascular invasion, lymph node metastasis, and perineural invasion.ConclusionsThe predictive capacity of postoperative recurrence and OS rates in ICC patients is effectively captured by the preoperative scoring system incorporating NLR and CA19-9 levels.

The Association Between Preoperative Neutrophil-Lymphocyte Ratio and Febrile Urinary Tract Infection in Patients Treated by Percutaneous Nephrolithotomy.

This study aimed to assess the association between preoperative neutrophil-lymphocyte ratio (NLR) and febrile urinary tract infection (fUTI) in patients who underwent percutaneous nephrolithotomy (PCNL). The clinical data of patients who underwent PCNL at our hospital between March 2020 and May 2023 were retrospectively analyzed. According to whether fUTI occurs after operation, collected data were divided to the patients into fUTI and non-fUTI. Univariate analysis, relative operating characteristic (ROC) curves and multivariate logistic regression analysis were performed on the data. A total of 405 patients were enrolled in the study. The procedure was successfully performed in all patients, and the incidence of fUTI was 8.4% (34/405). Eight patients eventually developed sepsis, and the incidence of sepsis in fUTI patients was 23.5%. The result shows a significant correlation between NLR and fUTI (95% confidence interval [CI],1.21-1.83, Odds ratio [OR]=1.49, p<0.001). The predictive ability of NLR on the occurrence of fUTI was assessed by plotting relative operating characteristic (ROC) curves. The area under the curve (AUC) in the ROC curve for NLR was 0.718 according to the Youden index, and the best cut-off value of NLR was 2.71. Furthermore, logistic multiple regression model adjustment was carried out to further confirm the robustness of the relationship between NLR and fUTI. The results indicated robustness regardless of whether NLR was a continuous variable or a categorical variable. NLR can be used as a simple and effective preoperative indicator for the prediction of fUTI in patients undergoing PCNL.

The Importance of Preoperative NLR, PLR, and MPV Values in Predicting the Risk of Complications in Colorectal Peritoneal Carcinomatosis.

Colorectal cancer peritoneal carcinomatosis (CRC PC) necessitates preoperative assessment of inflammatory markers to predict postoperative outcomes and guide treatment. This study aims to evaluate the prognostic value of preoperative Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) in predicting complications for CRC PC patients undergoing surgery. Calculating NLR, PLR, and MPV from patient data: NLR = absolute neutrophil count/total lymphocyte count, PLR = total lymphocyte count/total platelet count × 100, and MPV = platelet crit (PCT)/total platelet count. The study included 196 CRC PC patients and found significant relationships between these markers and overall survival (OS). Patients with an NLR of 3.77 had a median OS of 22.1 months, compared to 58.3 months for those with lower NLR (HR 2.7, 95% CI 1.1-5.3, p < 0.001). For CRC PC patients undergoing CRS+HIPEC, preoperative assessment of NLR, PLR, and MPV can serve as independent prognostic markers for OS. Incorporating these markers into preoperative evaluations may improve patient selection and outcome prediction.

Neutrophil-to-Lymphocyte Ratio and Prognostic Nutritional Index Are Predictors for Overall Survival after Primary Pancreatic Resection of Pancreatic Ductal Adenocarcinoma: A Single Centre Evaluation.

Prognostic inflammation-based parameters have been reported as useful tools in various oncologic diseases. Pancreatic ductal adenocarcinoma (PDAC) is characterized by a high mortality rate, making reliable prognostic markers highly desirable. However, there is still inconsistency in the literature regarding the efficacy of the different available scores. A total of 207 patients, who underwent primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, were included in this retrospective single-center study. Different biomarkers, including the preoperative neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the c-reactive protein (CRP)-albumin ratio (CAR), the lymphocyte-CRP ratio (LCR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGPS) were analyzed for their ability to predict overall survival (OS). In our cohort, the median overall survival was 20.7 months. Among the investigated biomarkers, NLR and PNI were identified as independent prognostic markers (Hazard Ratio (HR) 1.6 (1.0-2.5), p = 0.048 and HR 0.6 (0.4-0.9), p = 0.018), whereas PLR, CAR, LCR and mGPS did not reach significance in the multivariate analysis. Subgroup analysis revealed that the prognostic value of NLR and PNI is particularly evident in locally advanced tumor stages (pT3/4 and pN+). The NLR and PNI could serve as valuable tools for estimating prognosis in patients with PDAC undergoing pancreatic resection in curative intention, especially in locally advanced tumor stages. However, conflicting results in the current literature highlight the need for further prospective studies to validate these findings.

Association between admission inflammatory indicators and 3-year mortality risk in geriatric patients after hip fracture surgery: a retrospective cohort study.

Recent research indicates that the monocyte lymphocyte ratio (MLR), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), C-reactive protein (CRP), and systemic immune-inflammation index (SII) may serve as valuable predictors of early postoperative mortality in elderly individuals with hip fractures. The primary objective of the study was to examine the association between preoperative MLR, NLR, PLR, CRP, and SII levels and 3-year mortality risk in geriatric patients after hip fracture surgery. The study included patients aged 65 years or older who underwent hip fracture surgery between November 2018 and November 2019. Admission levels of MLR, NLR, PLR, CRP, and SII were measured. The median follow-up period was 3.1 years. Cox proportional hazards models were used to calculate the hazard ratio (HR) for mortality with adjusting for potential covariates. Time-dependent receiver operating characteristic (ROC) curves were employed to assess the predictive capability of inflammatory indicators for mortality. A total of 760 patients completed the follow-up (79.4 ± 7.8 years, 71.1% female). A higher preoperative MLR was found to be significantly associated with an increased 3-year postoperative mortality risk (HR 1.811, 95% CI 1.047-3.132, P = 0.034). However, no significant correlations were observed between preoperative NLR, PLR, CRP, SII and 3-year mortality. The areas under the ROC curve (AUCs) of MLR for predicting 30-day, 120-day, 1-year, and 3-year mortality were 0.74 (95% CI 0.53-0.95), 0.70 (95% CI 0.57-0.83), 0.67 (95% CI 0.60-0.74), and 0.61 (95% CI 0.56-0.66), respectively. Preoperative MLR is a useful inflammatory marker for predicting 3-year mortality in elderly hip fracture patients, but its predictive ability diminishes over time.

Association of Neutrophil-Lymphocyte Ratio and Red Blood Cell Distribution Width with Poor Outcome in Pediatric Cardiac Surgery - A Retrospective Observational Study.

Neutrophil-lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammatory response and red blood cell distribution width (RBDW), a routinely available biomarker of likely erythropoietic dysfunction, which may be associated with adverse outcomes after cardiac surgery. This study aimed to investigate the association between these two readily available haematological parameters, with the poor outcomes in paediatric patients undergoing cardiac surgery. A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes. The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36-0.70, cut off- 4.2) and RBDW (AUC=0.88, 95%CI 0.39-0.73, cut off- 18.5%) showed prognostic significance in the perioperative period. This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.

Preoperative Laboratory Values Predicting Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Total Hip or Knee Arthroplasty.

Morbidly obese patients are an ever-growing high-risk population undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) for end-stage osteoarthritis. This study sought to identify preoperative laboratory values that may serve as predictors of periprosthetic joint infection (PJI) in morbidly obese patients undergoing THA or TKA. All morbidly obese patients with preoperative laboratory data before undergoing primary elective TKA or THA were identified using the Premier Healthcare Database. Patients who developed PJI within 90 days after surgery were compared with patients without PJI. Laboratory value thresholds were defined by clinical guidelines or primary literature. Univariate and multivariable regression analyses were utilized to assess the association between PJI and preoperative laboratory values, including total lymphocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), albumin level, platelet count, albumin-globulin ratio, hemoglobin level, and hemoglobin A1c. Of the 6,780 patients identified (TKA: 76.67%; THA: 23.33%), 47 (0.69%) developed PJI within 90 days after surgery. The rate of PJI was 1.69% for patients with a hemoglobin level of <12 g/dL (for females) or <13 g/dL (for males), 2.14% for those with a platelet count of <142,000/µL or >417,000/µL, 1.11% for those with an NLR of >3.31, 1.69% for those with a PLR of >182.3, and 1.05% for those with an SII of >776.2. After accounting for potential confounding factors, we observed an association between PJI and an abnormal preoperative NLR (adjusted odds ratio [aOR]: 2.38, 95% confidence interval [CI]: 1.04 to 5.44, p = 0.039), PLR (aOR: 4.86, 95% CI: 2.15 to 10.95, p < 0.001), SII (aOR: 2.44, 95% CI: 1.09 to 5.44, p = 0.029), platelet count (aOR: 3.50, 95% CI: 1.11 to 10.99, p = 0.032), and hemoglobin level (aOR: 2.62, 95% CI: 1.06 to 6.50, p = 0.038). This study identified preoperative anemia, abnormal platelet count, and elevated NLR, PLR, and SII to be associated with an increased risk of PJI among patients with a body mass index of ≥40 kg/m 2 . These findings may help surgeons risk-stratify this high-risk patient population. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Predictive efficacy of the preoperative neutrophil–lymphocyte ratio in lymph node metastasis of cN0 hormone receptor-positive breast cancer

Breast cancer, as the most common cancer, has surpassed lung cancer worldwide. The neutrophil-to-lymphocyte ratio (NLR) has been linked to the onset of cancer and its prognosis in recent studies. However, quite a few studies have shown that there is a link between NLR and lymph node metastases in cN0 hormone receptor-positive (HR(+)) breast cancer. The purpose of this study was to evaluate the correlation between NLR and lymph node metastases in cN0 HR(+) breast cancer patients. From January 2012 to January 2022, 220 patients with cN0 HR(+) invasive breast cancers were enrolled in this study. The relationship between NLR and pathological data was statistically examined. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff of NLR, a chi-squared test was used for the univariate analysis, and logistic analysis was used for the multivariate analysis. The NLR had an optimal cutoff of 2.4 when the Jorden index was at a maximum. Patients with axillary lymph node metastases had a higher NLR (P < 0.05). A Univariate analysis showed that there were significant differences in cN0 HR(+) breast cancer with axillary lymph node metastasis among different clinical stages, histological grades, Ki-67 levels, tumor sizes, and NLR levels (P < 0.05). Clinical stage, tumor size, and NLR were found to be independent risk factors for lymph node metastases in multifactorial analysis. In cN0 HR(+) breast cancer, NLR is an independent risk factor for lymph node metastases. An NLR ≥ 2.4 indicates an increased probability of lymph node metastases. An elevated preoperative NLR has a high predictive value for axillary lymph node metastases.

AB033. SOH24AB_089. Assessing the clinical utility of preoperative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer

AB033. SOH24AB_089. Assessing the clinical utility of preoperative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer

AB071. SOH24AB_184. Evaluating preoperative neutrophil-lymphocyte ratio as a predictive biomarker in primary breast cancer

AB071. SOH24AB_184. Evaluating preoperative neutrophil-lymphocyte ratio as a predictive biomarker in primary breast cancer

Comparison of Preoperative and Postoperative Neutrophil/Lymphocyte Ratio in Predicting Mortality in Neonates with Intestinal Atresia

Abstract Objective Congenital intestinal atresia is one of the most common surgical pathologies in the neonatal period. This study aimed to compare the efficacy of preoperative neutrophil/lymphocyte ratio (NLR) and postoperative NLR in predicting early mortality in neonates with intestinal atresia. Methods The data of 38 newborns with intestinal atresia operated on in our hospital between January 2016 and March 2023 were retrospectively analyzed. Patients' gestational age, gender, birth weight, other congenital anomalies, operative findings, length of hospital stay, sepsis, and mortality rates were recorded. NLR was calculated by analyzing preoperative and postoperative day 1 complete blood tests. Results Of the patients included in the study, 60.5% were male and 39.5% were female. The median birth weight was 2,468 g (600–3,800 g), and the median gestational age was 36 weeks (28–40 weeks). Gender, number of areas of atresia in the gut, and development of sepsis were not associated with mortality. Mortality was observed at a lower rate in duodenal atresia when compared with the other types of atresia (p &lt; 0.05). The mortality was higher in patients with prematurity, low birth weight, long duration of mechanical ventilation, and severe congenital anomalies (p &lt; 0.05). Preoperative lymphocyte and neutrophil counts were not found to be predictive of mortality. The mortality rate increased as the postoperative lymphocyte count decreased and as the neutrophil count increased (p &lt; 0.05). The preoperative and postoperative NLR was not useful in predicting mortality, the development of sepsis, or the need for reoperation. Conclusion It is possible to predict early mortality in newborns with intestinal atresia who underwent surgery with neutrophil and lymphocyte counts on the first day after surgery. However, early NLR is not useful in predicting prognosis after surgery in newborns.

Relation between neutrophil-to-lymphocyte ratio with epidural analgesia timing and thoracotomy pain.

This study investigated the relationship of the pre-operative neutrophil/lymphocyte ratio (NLR) to the timing of epidural analgesia administration and post-operative acute and chronic pain in thoracotomy. The study was conducted on 60 patients, with NLR ≥ 2 (Group A) and NLR < 2 (Group B). Each group was divided into subgroups pre-emptive analgesia (Group P) and control group (Group C). Epidural analgesic solution was administered as a bolus before the surgical incision in Group P and at the end of the operation in Group C. NRS was questioned postoperatively at the 2nd, 4th, 8th, 12th, 24th h, 1st, and 3rd months and also additional analgesic needs were recorded. In Group A, the pain scores of the patients who received pre-emptive epidural analgesia were lower at the post-operative 2nd, 4th, and 8th h and analgesic consumption was less in the post-operative first 24 h. It was observed that pre-emptive epidural analgesia reduced pain levels and additional analgesic consumption in the acute post-operative period in patients with pre-operative NLR ≥ 2.