Neutrophil to Lymphocyte Ratio Predicts Perioperative Mortality Following Open Elective Repair of Abdominal Aortic Aneurysms
Neutrophil to Lymphocyte Ratio Predicts Perioperative Mortality Following Open Elective Repair of Abdominal Aortic Aneurysms
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DOI：
10.1177/1538574413519713
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发表时间：
2014-05-01
影响因子：
0.9
通讯作者：
Lewis, M. H.
中科院分区：
文献类型：
--
作者：
Appleton, N. D.;Bailey, D. M.;Lewis, M. H.
目的：本研究评估中性粒细胞与淋巴细胞比率 (NLR) 对开放性腹主动脉瘤 (AAA) 修复术后 30 天死亡率和总体死亡率的预测价值。此外，它还评估了 NLR 与年龄、AAA 大小和性别之间的相关性。方法：纳入了在 10 年期间由一位外科医生对 AAA 进行选择性或紧急开放性修复的患者。术前NLR>5被视为异常。结果：连续350名患者接受了AAA修复。 52 人的 NLR>5。 NLR>5组的30天死亡率为12/52（23%），NLR5组的30天死亡率为20/298（6.7%），原因是心肌梗塞。 30 天内死亡的患者的中位 NLR 较高，分别为 4.2 [IQR：2.6-7.5] 和 2.8 [IQR：2.1-3.8]（p = 0.0001）。 NLR>5 组的 10 年总死亡率为 26/52 (50%)，显着高于 NLR5 组的 3.2 (IQR 2.5-4.6)，而存活者的 10 年总死亡率为 2.6 (IQR：2.0-3.6) (p = 0.00004)。 NLR 与年龄、动脉瘤大小或性别之间没有发现差异。结论：术前 NLR>5 似乎是择期和紧急开放 AAA 手术中 30 天死亡率和长期结果的显着预测因子。 NLR 可能正在识别一群患有亚临床心血管疾病且有围手术期心肌梗死风险的人群。
Objectives: This study assesses the predictive value of neutrophil to lymphocyte ratio (NLR) in relation to 30-day and overall mortality following open abdominal aortic aneurysm (AAA) repairs. In addition, it assess assesses any correlation between NLR and age, size of the AAA and gender.Methods: Patients undergoing elective or urgent open repair of their AAA by a single surgeon during a 10-year period were included. A pre-operative NLR of >5 was regarded as abnormal.Results: 350 consecutive patients underwent AAA repair. 52 had an NLR>5. 30-day mortality rate was 12/52 (23%) in the NLR>5 group and 20/298 (6.7%) in the NLR5 group were due to myocardial infarction. The median NLR was higher in those that died within 30 days at 4.2 [IQR: 2.6-7.5] versus 2.8 [IQR: 2.1-3.8] (p = 0.0001). Overall mortality at 10 years, in the NLR>5 group - 26/52 (50%) was significantly greater than that of the NLR5 at 3.2 (IQR 2.5-4.6) versus 2.6 (IQR: 2.0-3.6) in those surviving (p = 0.00004). No difference was found between NLR and age, aneurysm size or gender.Conclusion: Pre-operative NLR>5 appears to be a significant predictor of both 30-day mortality and long-term outcome in elective and urgent open AAA surgery. It is plausible the NLR is identifying a group with sub-clinical cardiovascular disease at risk of peri-operative myocardial infarction.