The Relationship Between Preoperative Neutrophil–Lymphocyte Ratio and Postoperative Length of Stay in Carotid Body Tumor Resection

Carotid body tumor (CBT) resection is a complex surgical procedure often resulting in extended postoperative length of stay (PLOS) due to potential nerve injuries, arterial damage, and wound complications. The neutrophil-to-lymphocyte ratio (NLR) is a known marker of systemic inflammation and has been associated with adverse outcomes in various surgical settings. However, the relationship between preoperative NLR and PLOS in CBT patients has not been explored. This study aims to investigate the association between preoperative NLR and PLOS in CBT resections, particularly examining whether elevated NLR correlates with longer hospital stays and potentially hinders recovery. In this retrospective cohort study, we analyzed data from 231 CBT patients who underwent resection at Changhai Hospital, Shanghai, between 2008 and 2020. Patients were grouped based on their PLOS (short, medium, and long stays), and NLR was calculated from peripheral blood samples taken preoperatively. Univariate and multivariate regression models adjusted for sociodemographic and operative factors, including Shamblin classification, were used to examine the relationship between NLR and PLOS. Elevated preoperative NLR has been found to be significantly correlated with prolonged PLOS, with each incremental increase in NLR corresponding to an approximate extension of 0.12 days in PLOS after adjusting for confounding factors. Stratified analysis revealed that this association was most pronounced in patients with Shamblin II tumors, likely due to the moderate tumor size and adhesion in these cases, which necessitates more extensive dissection and increases vulnerability to nerve injury. Elevated preoperative NLR may serve as a predictor of prolonged recovery in CBT resections, particularly for Shamblin II cases. This finding highlights the potential utility of NLR in preoperative assessment and patient management to optimize surgical timing and reduce hospital stays. Further research with larger cohorts is needed to confirm the predictive value of NLR and explore its clinical application in surgical planning for CBT patients.