Neutrophil/Lymphocyte Ratio Can Predict Postoperative Mortality in Patients with Chronic Thromboembolic Pulmonary Hypertension

Yanartaş, Mehmed; Kalkan, Mehmet; Arslan, Akın; Taş, Serpil; Köksal, Cengiz; Bekiroğlu, Nural; Yıldızeli, Bedrettin

doi:10.5761/atcs.oa.14-00190

Cited by 18 publications

(15 citation statements)

References 24 publications

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“…In the present study, we aimed to determine the role of preoperative NLCR in predicting sepsis after PCNL. Several cutoff values have been reported in the literature; however, the ideal cutoff is controversial [29–31]. The threshold for NLCR provided by the ROC analysis in our study was 2.50.…”

Section: Discussionmentioning

confidence: 62%

“…Yanartas et al. [30] evaluated the role of preoperative NLCR in predicting postoperative mortality in patients with chronic thromboembolic pulmonary hypertension. They found that a high NLCR at admission was significantly associated with high mortal‐ity rates.…”

Section: Discussionmentioning

confidence: 99%

“…However, SIRS or sepsis was not seen in some of the cases with NLCR ≥ 2.50. NLCR has been investigated in several diseases including hypertension, malignant diseases, Behcet's disease, and rheumatoid arthritis, and it was shown that NLCR could be effected from these diseases and smoking [18–21,27,30,32–35]. The higher NLCR values in SIRS/sepsis (−) patients may be related with these comorbidities.…”

Section: Discussionmentioning

confidence: 99%

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Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

Şen

Bozkurt

Aydoğdu

et al. 2016

The Kaohsiung J of Med Scie

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We evaluated the usefulness of preoperative neutrophil-lymphocyte count ratio (NLCR) in predicting postoperative sepsis after percutaneous nephrolithotomy (PCNL). In total, 487 patients who underwent PCNL for renal stones were included in the present retrospective study. The stone burden, number of tracts and location, operation time, fluoroscopy time, presence of residual stones, and blood transfusion rates were postoperatively recorded in all patients. All patients were followed up for signs of systemic inflammatory response syndrome (SIRS) and sepsis. The association of sepsis/SIRS with the risk factors of infectious complications, including NLCR, was evaluated. SIRS was detected in 91 (18.7%) patients, 25 (5.1%) of whom were diagnosed with sepsis. Stone burden, operation time, irrigation rate, previous surgery, nephrostomy time, access number, blood transfusion, residual stone, postoperative urinary culture, renal pelvis urinary culture, and stone culture were found to be predictive factors for SIRS and sepsis development. Receiver operating characteristic curve analysis revealed an NLCR cutoff of 2.50 for predicting the occurrence of SIRS/sepsis. We found that the incidence of sepsis was significantly higher in patients with NLCR ≥ 2.50 than in patients with NLCR < 2.50 (p = 0.006). Preoperative and postoperative urine culture positivity were associated with high NLCR (p = 0.039 and p = 0.003, respectively). We believe that preoperative NLCR may be a promising additive predictor of bacteremia and postoperative sepsis in patients who undergo PCNL for renal stones. This marker is simple, easily measured, and easy to use in daily practice without extra costs.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

Şen

Bozkurt

Aydoğdu

et al. 2016

The Kaohsiung J of Med Scie

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“…Recently, the neutrophil/lymphocyte ratio (NLR) has been proposed as a new inflammatory biomarker and can be used as an indicator of systemic inflammation in many diseases, including PAH. In patients with CTEPH or PAH with sarcoidosis, NLR correlated significantly with pulmonary vascular resistance [ 133 , 134 ]. Similarly, NLR correlated with important prognostic biomarkers in PAH patients [ 135 ], and high NLR was associated with high morbidity and mortality in patients undergoing thromboendarterectomy [ 134 ].…”

Section: Inflammatory Mediators and Their Effects On Vascular Remomentioning

confidence: 99%

Perivascular Inflammation in Pulmonary Arterial Hypertension

Chi

Kuebler

et al. 2020

Cells

139

109

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Perivascular inflammation is a prominent pathologic feature in most animal models of pulmonary hypertension (PH) as well as in pulmonary arterial hypertension (PAH) patients. Accumulating evidence suggests a functional role of perivascular inflammation in the initiation and/or progression of PAH and pulmonary vascular remodeling. High levels of cytokines, chemokines, and inflammatory mediators can be detected in PAH patients and correlate with clinical outcome. Similarly, multiple immune cells, including neutrophils, macrophages, dendritic cells, mast cells, T lymphocytes, and B lymphocytes characteristically accumulate around pulmonary vessels in PAH. Concomitantly, vascular and parenchymal cells including endothelial cells, smooth muscle cells, and fibroblasts change their phenotype, resulting in altered sensitivity to inflammatory triggers and their enhanced capacity to stage inflammatory responses themselves, as well as the active secretion of cytokines and chemokines. The growing recognition of the interaction between inflammatory cells, vascular cells, and inflammatory mediators may provide important clues for the development of novel, safe, and effective immunotargeted therapies in PAH.

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“…In PAH patients, an increased neutrophil-to-lymphocyte ratio in peripheral blood samples positively correlates with the NYHA FC and a negative ratio can even predict event-free survival [45,46]. In CTEPH patients, the neutrophil-to-lymphocyte ratio could predict postoperative mortality and might be used as a noninvasive measuring tool for operative risk stratification [47]. Currently, it is unclear if and how neutrophils contribute to PAH progression.…”

Section: Neutrophilsmentioning

confidence: 99%

Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: An Immunological Perspective

Koudstaal

Boomars

Kool

2020

JCM

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Pulmonary hypertension (PH) is a debilitating progressive disease characterized by increased pulmonary arterial pressures, leading to right ventricular (RV) failure, heart failure and, eventually, death. Based on the underlying conditions, PH patients can be subdivided into the following five groups: (1) pulmonary arterial hypertension (PAH), (2) PH due to left heart disease, (3) PH due to lung disease, (4) chronic thromboembolic PH (CTEPH), and (5) PH with unclear and/or multifactorial mechanisms. Currently, even with PAH-specific drug treatment, prognosis for PAH and CTEPH patients remains poor, with mean five-year survival rates of 57%–59% and 53%–69% for PAH and inoperable CTEPH, respectively. Therefore, more insight into the pathogenesis of PAH and CTEPH is highly needed, so that new therapeutic strategies can be developed. Recent studies have shown increased presence and activation of innate and adaptive immune cells in both PAH and CTEPH patients. Moreover, extensive biomarker research revealed that many inflammatory and immune markers correlate with the hemodynamics and/or prognosis of PAH and CTEPH patients. Increased evidence of the pathological role of immune cells in innate and adaptive immunity has led to many promising pre-clinical interventional studies which, in turn, are leading to innovative clinical trials which are currently being performed. A combination of immunomodulatory therapies might be required besides current treatment based on vasodilatation alone, to establish an effective treatment and prevention of progression for this disease. In this review, we describe the recent progress on our understanding of the involvement of the individual cell types of the immune system in PH. We summarize the accumulating body of evidence for inflammation and immunity in the pathogenesis of PH, as well as the use of inflammatory biomarkers and immunomodulatory therapy in PAH and CTEPH.

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Neutrophil/Lymphocyte Ratio Can Predict Postoperative Mortality in Patients with Chronic Thromboembolic Pulmonary Hypertension

Cited by 18 publications

References 24 publications

Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

Perivascular Inflammation in Pulmonary Arterial Hypertension

Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: An Immunological Perspective

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