Is the Neutrophil-to-Lymphocyte Ratio more correlated than C-reactive protein with postoperative complications after major abdominal surgery?

Abstract

Background. The Neutrophil-to-Lymphocyte Ratio (NLR) is an inflammatory marker that has proven usefulness for predicting late complications. Whether it is associated with immediate postoperative complications after abdominal surgery is not known. In this study, we attempted to correlate the NLR and the C-reactive protein (CRP) with postoperative complications rate.Methods. We performed a post-hoc analysis of previously collected data concerning 82 consecutive patients (median age: 62 years, range: 27–80, female/male 32/50) undergoing major abdominal surgeries. For each patient, we recorded preoperative characteristics, the NLR and CRP values, and postoperative complications (between D + 8 and D + 30) such as infections (N = 29), cardiovascular complications (N = 12) and other complications (N = 28). We performed uni- and multivariate analyses using logistic/linear regression models.Results. Patients with complications did not present a higher preoperative NLR than those without, but a higher ratio at D + 7 (10.73 ± 9.86 vs. 4.73 ± 3.38 without complication) (P < 0.001). In the univariate analysis, the NLR at D + 7 was associated with postoperative complications (P < 0.001). At D + 7, in the multivariate analysis, an increased NLR was associated with more complications (P < 0.001), whereas none of the other factors, including CRP, showed any correlation.Conclusion. Postoperative NLR at day 7 after major abdominal surgery is associated with complications during the first postsurgical month, in contrast with the CRP level. The NLR is a simple and interesting parameter in the perioperative period.

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

“…The NLR has already been associated with the early mortality and morbidity of patients with malignancies, cardiovascular disease or chronic renal failure [8,25,26]. Forget et al [8] showed that in multivariate analysis, a higher value of NLR on POD7 was associated with postoperative complications, whereas the concentration of CRP did not show any such correlation.…”

“…Forget et al [8] showed that in multivariate analysis, a higher value of NLR on POD7 was associated with postoperative complications, whereas the concentration of CRP did not show any such correlation. In our study, we compared the mean values of NLR on POD4 and observed a significant correlation with AL, as well as with overall mortality and the mortality associated with AL.…”

“…An increased NLR is associated with poor, late prognosis of various malignancies, including pancreatic or oesophageal cancer [6,7]. Recently, NLR has also been evaluated as a predictor of major postoperative complications in abdominal surgery [8]. However, the prognostic role of NLR in the prediction of early intraabdominal complications after surgery in CRC patients is still unclear and needs to be evaluated.…”

Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer

“…Forget et al (2015) have found that NLR was signifi cantly associated with postoperative complications of major abdominal surgery than CRP.…”

Biomarkers in immunonutrition programme, is there still a need for new ones? A brief review

“…However, there are a lot of contradictions between the results of scientific studies and use of this marker in practice. For example, serum albumin level is not well correlated to protein mass, is affected by distribution and dilution (leading to discordance with other marker, especially after surgery), and is now more considered as a disease severity/prognostic marker as in cancer [31, 32]. Moreover, serum albumin does not always significantly increase after nutritional programmes [16].…”