Higher neutrophil-to-lymphocyte ratio, mean platelet volume, and platelet distribution width are associated with postoperative delirium in patients undergoing esophagectomy: a retrospective observational study
Higher neutrophil-to-lymphocyte ratio, mean platelet volume, and platelet distribution width are associated with postoperative delirium in patients undergoing esophagectomy: a retrospective observational study
复制标题
DOI：
10.1007/s00540-021-03007-6
复制
发表时间：
2021-09-30
影响因子：
2.8
通讯作者：
Hirota, Kazuyoshi
中科院分区：
文献类型：
--
作者：
Oyama, Tasuku;Kinoshita, Hirotaka;Hirota, Kazuyoshi
目的我们研究了术前炎症标志物，血小板-淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）、平均血小板体积（MPV）和血小板分布宽度（PDW）可预测食管癌术后谵妄（POD）的发生。患者和方法这项单中心、回顾性、观察性研究包括110例接受食管切除术的患者。我们将重症监护谵妄筛查量表评分>= 4的患者分配到POD组。我们进行了多变量逻辑回归分析，以确定是否NLR，PLR，MPV和PDW可以用来预测POD的发展。结果POD组20例，非POD组90例。虽然仅POD组的术前NLR显著高于非POD组，（3.20 [2.52-4.30] vs. 2.05 [1.45-3.02]，p = 0.001），多变量logistic回归分析显示以下三个参数是POD的独立预测因素：术前NLR >= 2.45（调整后比值比[aOR]：8.68，95%CI 2.33-32.4，p = 0.001），MPV >= 10.4（aOR：3.93，95%CI：1.37-11.2，p = 0.011），PDW >= 11.8（aOR：3.58，95%CI：1.22-10.5，p = 0.020）。结论我们的分析结果表明，在调整可能的混杂因素后，术前NLR >= 2.45，MPV >= 10.4，PDW >= 11.8与POD的高风险显著相关。然而，由于在单变量ROC分析中，术前MPV和PDW预测POD发展的AUC较低，因此需要进行大型前瞻性研究来证实这一结果。
Purpose We investigated whether preoperative inflammatory markers, i.e., the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) can predict the development of postoperative delirium (POD) after esophagectomy. Patients and methods This single-center, retrospective, observational study included 110 patients who underwent an esophagectomy. We assigned the patients with the Intensive Care Delirium Screening Checklist score >= 4 to the POD group. We performed multivariable logistic regression analyses to determine whether the NLR, PLR, MPV, and PDW can be used to predict the development of POD. Results The POD group had 20 patients; the non-POD group included the other 90 patients. Although only the preoperative NLR in the POD group was significantly higher than in the non-POD group (3.20 [2.52-4.30] vs. 2.05 [1.45-3.02], p = 0.001), multivariable logistic regression analyses showed that the following three parameters were independent predictors of POD: preoperative NLR >= 2.45 (adjusted odds ratio [aOR]: 8.68, 95%CI 2.33-32.4, p = 0.001), MPV >= 10.4 (aOR: 3.93, 95%CI: 1.37-11.2, p = 0.011), and PDW >= 11.8 (aOR: 3.58, 95%CI: 1.22-10.5, p = 0.020). Conclusion Our analysis results demonstrated that preoperative NLR >= 2.45, MPV >= 10.4, and PDW >= 11.8 were significantly associated with a higher risk of POD after adjustment for possible confounding factors. However, as the AUCs of the preoperative MPV and PDW for the prediction of the development of POD in univariable ROC analyses were low, large prospective studies are needed to confirm this result.