Neutrophil-to-Lymphocyte Ratio as a Biomarker for Postoperative Complications in Crohn's Disease.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-05-01 DOI:10.21873/invivo.13958

Makoto Kawamoto, Daijiro Higashi, Ken Kinjo, Noritaka Takatsu, Yoshihiro Miyasaka, Hisatomi Arima, Satoshi Nimura, Takashi Hisabe, Masato Watanabe

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引用次数: 0

Abstract

Background/aim: Despite advances in diagnosis and pharmacotherapy, surgery remains crucial for Crohn's disease (CD). Postoperative intra-abdominal septic complications (IASC) occur in 1.2-16.7% of cases. We investigated the frequency of postoperative IASC in elective surgeries for CD and the risk factors and potential biomarkers for postoperative IASC.

Patients and methods: We conducted a retrospective single-center cohort study of patients who underwent abdominal surgery for CD at Fukuoka University Chikushi Hospital between January 2015 and December 2023. The primary focus was the incidence of IASC within 60 days postoperatively. Patient-related variables were examined using univariate and multivariable analyses.

Results: The analysis included 206 of 249 surgeries. Postoperative IASC occurred in 26 patients (12.6%). Univariate analysis identified history of steroid use requiring steroid coverage (p=0.002), penetrating type (p=0.020), WBC count (p=0.037), neutrophil count (0.009), C-reactive protein (CRP) (p=0.035), CRP-albumin ratio (CAR) (p=0.034), neutrophil-to-lymphocyte ratio (NLR) (p=0.002), and operation duration (p=0.010) as significant factors. Multivariable analysis identified history of steroid use requiring steroid coverage (OR=6.23, 95%CI=1.61-24.1, p=0.008), high NLR (OR=3.43, 95%CI=1.30-9.04, p=0.013), and long duration of operation (OR=2.63, 95%CI=1.01-6.88, p=0.049) as independent predictors. The optimal cutoffs for predicting IASC were an NLR of 3.98 (sensitivity, 61.5%; specificity, 77.8%) and an operation time of 173 min (sensitivity, 65.4%; specificity, 65.0%), respectively.

Conclusion: History of steroid use requiring steroid coverage, preoperative NLR ≧3.98, and duration of operation ≧173 min are independent risk factors for postoperative IASC in elective surgeries for CD. Recognition of high-risk patients would contribute to the decision-making process for perioperative management.

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中性粒细胞与淋巴细胞比值作为克罗恩病术后并发症的生物标志物。

背景/目的：尽管在诊断和药物治疗方面取得了进展，但手术治疗克罗恩病（CD）仍然至关重要。术后腹腔内脓毒性并发症（IASC）发生率为1.2-16.7%。我们调查了CD择期手术术后IASC的频率，以及术后IASC的危险因素和潜在生物标志物。患者和方法：我们对2015年1月至2023年12月期间在福冈大学千古医院（Fukuoka University Chikushi Hospital）接受腹部手术治疗CD的患者进行了回顾性单中心队列研究。主要关注术后60天内IASC的发生率。采用单变量和多变量分析检查患者相关变量。结果：分析249例手术中的206例。术后IASC 26例（12.6%）。单因素分析发现，需要类固醇覆盖的类固醇使用史（p=0.002）、穿透类型（p=0.020）、WBC计数（p=0.037）、中性粒细胞计数（0.009）、c反应蛋白（CRP）（p=0.035）、CRP-白蛋白比（CAR）（p=0.034）、中性粒细胞-淋巴细胞比（NLR）（p=0.002）和手术时间（p=0.010）是显著因素。多变量分析确定需要类固醇覆盖的类固醇使用史（OR=6.23, 95%CI=1.61-24.1, p=0.008）、高NLR （OR=3.43, 95%CI=1.30-9.04, p=0.013）和手术时间长（OR=2.63, 95%CI=1.01-6.88, p=0.049）为独立预测因素。预测IASC的最佳截止值为NLR为3.98(灵敏度为61.5%；特异性77.8%)，手术时间173 min(敏感性65.4%；特异性为65.0%)。结论：类固醇用药史、术前NLR≧3.98、手术时间≧173 min是CD择期手术术后IASC发生的独立危险因素，对高危患者的识别有助于围手术期管理决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.