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. 2022 Apr 15:13:145.
doi: 10.25259/SNI_160_2022. eCollection 2022.

Preoperative lymphocyte percentage and neutrophil-lymphocyte ratio are useful predictors of 30-day postoperative complications after lumbar fusion

Temidayo Osunronbi #  1   2 , Balint Borbas #  3 , Hiba Lusta  3 , Agbolahan Sofela  4 , Himanshu Sharma  4
Affiliations

Preoperative lymphocyte percentage and neutrophil-lymphocyte ratio are useful predictors of 30-day postoperative complications after lumbar fusion

Temidayo Osunronbi et al. Surg Neurol Int. .

Abstract

Background: Lymphocyte percentage/count, platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) have shown prognostic significance in patients with cancer, stroke, and following cardiac surgery. However, the utility of these blood parameters for assessing the 30-day postoperative risk for lumbar fusion complications has not been established.

Methods: In this single-center-single-surgeon retrospective series, 77 consecutive patients underwent one- or two-level lumbar fusion. Lymphocyte percentage/count, PLR, and NLR were investigated as predictors of 30-day postoperative complications.

Results: Ten of 77 patients had postoperative complications. A unit increase in NLR and lymphocyte percentage was significantly associated with a 23% increase and 7% decrease, respectively, in the odds of a complication occurring. Preoperative NLR ≥ 2.32 and lymphocyte percentage ≤ 29.5% significantly discriminated between the "complication" and "no-complication" groups.

Conclusion: Patients with a preoperative lymphocyte percentage of ≤29.5% and/or NLR ≥2.32 should be closely monitored as high-risk groups susceptible to 30-day postoperative complications after lumbar fusion.

Keywords: Complications; Lymphocyte; Neutrophil; Prognosis; Spinal fusion.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Incidence and types of postoperative complications (n = 77). SSI: Surgical site infection, TIA: Transient ischemic attack.
Figure 2:
Figure 2:
Odds ratio with 95% confidence interval for the occurrence of complications within 30 days after lumbar fusion according to demographic/surgical/laboratory parameters. a compared to female, b compared to nonsmokers, c compared to two-level fusion. *Statistically significant.
Figure 3:
Figure 3:
ROC analysis for preoperative (a) neutrophillymphocyte ratio and (b) lymphocyte percentage in discriminating between complication and no complication patients after lumbar fusion.
Figure 4:
Figure 4:
Odds ratio with 95% confidence interval for the occurrence of complications according to NLR and lymphocyte percentage cutoff values. a compared to NLR less than 2.32, b compared to lymphocyte percentage greater than 29.5%. *Statistically significant.
See this image and copyright information in PMC

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