Blood cell count indexes as predictors of anastomotic leakage in elective colorectal surgery: a multicenter study on 1432 patients
Blood cell count indexes as predictors of anastomotic leakage in elective colorectal surgery: a multicenter study on 1432 patients
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DOI：
10.1186/s12957-020-01856-1
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发表时间：
2020-05-06
影响因子：
3.2
通讯作者：
Zorcolo, Luigi
中科院分区：
文献类型：
--
作者：
Paliogiannis, Panagiotis;Deidda, Simona;Zorcolo, Luigi
本研究的目的是评估一系列血细胞计数炎症指标在预测择期结直肠手术吻合口瘘（AL）中的作用。方法回顾性分析了8个外科中心1432例接受结直肠手术患者的人口统计学、病理学和临床资料。分别于术前、术后第1天和第4天测定中性粒细胞/淋巴细胞（NLR）、衍生中性粒细胞/淋巴细胞（dNLR）、淋巴细胞/单核细胞（LMR）和血小板/淋巴细胞（PLR）比值。在术后第1天和第4天，AL患者的NLR、dNLR和PLR均显著高于无AL患者，但在术后第4天显著性更高。这一天的NLR截止值为7.1，显示了最佳曲线下面积（AUC 0.744;结论在所评价的炎性指标中，术后第4天的NLR对AL的预测能力最强，NLR是一种成本低、操作简便、应用广泛的指标，这可能是潜在的用于临床实践中作为一个预测AL患者接受择期结直肠手术。
Background The aim of this study was to evaluate a series of blood count inflammation indexes in predicting anastomotic leakage (AL) in elective colorectal surgery. Methods Demographic, pathologic, and clinical data of 1432 consecutive patients submitted to colorectal surgery in eight surgical centers were retrospectively evaluated. The neutrophil to lymphocyte (NLR), derived neutrophil to lymphocyte (dNLR), lymphocyte to monocyte (LMR), and platelet to lymphocyte (PLR) ratios were calculated before surgery and on the 1st and 4th postoperative days, in patients with or without AL. Results There were 106 patients with AL (65 males, mean age 67.4 years). The NLR, dNLR, and PLR were significantly higher in patients with AL in comparison to those without, on both the 1st and 4th postoperative days, but significance was greater on the 4th postoperative day. An NLR cutoff value of 7.1 on this day showed the best area under the curve (AUC 0.744; 95% CI 0.719-0.768) in predicting AL. Conclusions Among the blood cell indexes of inflammation evaluated, NLR on the 4th postoperative day showed the best ability to predict AL. NLR is a low cost, easy to perform, and widely available index, which might be potentially used in clinical practice as a predictor of AL in patients undergoing elective colorectal surgery.